Comparative Analysis of Surgical and Pathological Outcomes between Laparoscopic and Open Rectal Cancer Surgeries: Single Institution Experience

Abstract

Background: The purpose of our review is to analyze and compare the perioperative and clinicopathologic outcomes of laparoscopic-assisted rectal surgeries (LARS) and open rectal surgeries (ORS) for rectal malignancies. Patients and methods: A retrospective analysis of data available from June 2015 to October 2018 was performed. Patient’s demographic profile, tumor characteristics, perioperative, and short-term clinicopathological outcomes were compiled and contrasted. Statistical tests used were Student’s t test and Fischer’s exact test. Results: During the study period, 34 and 24 patients underwent laparoscopic and open rectal cancer surgeries, respectively. Of 58 patients, there were 30 men (51.7%) and 28 women (48.3%) with average age group of 51.7 years. The median tumor distance was 4 cm and 6 cm from the anal verge in the laparoscopic and open groups, respectively ( p = 0.03). 70.1% of patients underwent preoperative chemoradiation. Conversion rate noted was 14.7%. Operative duration was prolonged for laparoscopic resection (194.7 vs 178.3 minutes, p = 0.168). Blood loss (395.58 vs 506.66 mL), postoperative hospital stay (8.3 vs 11.5 days: mean difference, 3.2 days), 30-day mortality (3% vs 0% p = 0.81), and major complications (11.8% vs 16.7%) failed to differ significantly. Negative circumferential radial margin was noticed in 98.4% of the overall group (94.1% laparoscopic resection and 95.8% open resection; p = 0.93). Conclusion: There were certainly no significant differences between laparoscopic and open surgeries in operative time period, complications, and duration of hospital stay. Hence, laparoscopic surgery is oncologically safe in rectal cancer patients. Clinical significance: Laparoscopic rectal as open with less morbidity, even among patients treated with preoperative chemoradiation.