Annals of Surgical Oncology

, Volume 15, Issue 9, pp 2418–2425

Laparoscopic-Assisted Versus Open Abdominoperineal Resection for Low Rectal Cancer: A Prospective Randomized Trial

  • Simon S. M. Ng
  • Ka Lau Leung
  • Janet F. Y. Lee
  • Raymond Y. C. Yiu
  • Jimmy C. M. Li
  • Anthony Y. B. Teoh
  • Wing Wa Leung
Gastrointestinal Oncology

DOI: 10.1245/s10434-008-9895-0

Cite this article as:
Ng, S.S.M., Leung, K.L., Lee, J.F.Y. et al. Ann Surg Oncol (2008) 15: 2418. doi:10.1245/s10434-008-9895-0

Abstract

Background

Laparoscopic resection of colonic cancer has been shown to improve postoperative recovery without jeopardizing tumor clearance and survival, but information on low rectal cancer is scarce. The aim of this randomized trial was to compare postoperative recovery between laparoscopic-assisted versus open abdominoperineal resection (APR) in patients with low rectal cancer. Recurrence and survival data were also recorded and compared between the two groups.

Methods

Between September 1994 and February 2005, 99 patients with low rectal cancer were randomized to receive either laparoscopic-assisted (51 patients) or conventional open (48 patients) APR. The median follow-up time of living patients was about 90 months for both groups. The primary and secondary endpoints of the study were postoperative recovery and survival, respectively. Data were analyzed by intention-to-treat principle.

Results

The demographic data of the two groups were comparable. Postoperative recovery was better after laparoscopic surgery, with earlier return of bowel function (P < .001) and mobilization (P = .005), and less analgesic requirement (P = .007). This was at the expense of longer operative time and higher direct cost. There were no differences in morbidity and operative mortality rates between the two groups. After curative resection, the probabilities of survival at 5 years of the laparoscopic-assisted and open groups were 75.2% and 76.5% respectively (P = .20). The respective probabilities of being disease-free were 78.1% and 73.6% (P = .55).

Conclusions

Laparoscopic-assisted APR improves postoperative recovery and seemingly does not jeopardize survival when compared with open surgery for low rectal cancer. A larger sample size is needed to fully assess oncological outcomes.

Keywords

LaparoscopyLaparoscopic-assistedAbdominoperineal resectionRectal cancerRandomized trial

Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Simon S. M. Ng
    • 1
  • Ka Lau Leung
    • 1
  • Janet F. Y. Lee
    • 1
  • Raymond Y. C. Yiu
    • 1
  • Jimmy C. M. Li
    • 1
  • Anthony Y. B. Teoh
    • 1
  • Wing Wa Leung
    • 1
  1. 1.Department of Surgery, The Chinese University of Hong KongPrince of Wales HospitalShatinHong Kong