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Long-term outcomes of laparoscopic surgery versus open resection for middle and lower rectal cancer: an NTCLES study

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Abstract

Background

Prognoses for treatment of middle and lower rectal cancer remain unclear because anatomical and complex surgical procedures specifically influence long-term outcomes. This study analyzes the long-term outcomes of laparoscopic versus open resection for middle and lower rectal cancer.

Methods

Patients (laparoscopic, n = 113; open, n = 123) who underwent curative resection for middle and lower rectal cancer from 2000 to 2005 participated in the study. All operations were performed by the same surgical team with extensive experience in laparoscopic and open procedures. The mean follow-up time of all patients was 74.8 months.

Results

No statistical differences in local recurrence rate (9.1% vs. 6.4%; log-rank = 0.432; p = 0.511) and in distant recurrence rate (19.7% vs. 15.5%; log-rank = 0.505; p = 0.477) between laparoscopic and open groups were observed within 5 years. The 5-year overall survival rates of the laparoscopic and open groups were 77.9 and 78.9%, respectively; no significant statistical difference was observed between them (log-rank = 0.012; p = 0.913). The 5-year survival rates between groups were not different between stages: stage I (91.7% vs. 92.0%; p = 0.950), stage II (82.8% vs. 79.4%; p = 0.643), and stage III (66.7% vs. 70.3%; p = 0.850). However, significant statistical differences between different stages were observed (log-rank = 11.156; p = 0.004).

Conclusion

Laparoscopic and open surgery for middle and lower rectal cancer offer similar long-term outcomes. The continued use of laparoscopic surgery in these patients can be supported.

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Acknowledgments

The authors are grateful to the insightful work provided to the leaders of the National Training Center of Laparo-Endoscopic Surgery, all of the fellows at the Computer Technology Center, and students who contributed to some of the studies discussed in this article.

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Authors and Affiliations

  1. Department of Colorectal and Anal Surgery, Fujian Medical University Union Hospital, Xinquan Road No. 29, Fuzhou, Fujian, 350001, People’s Republic of China

    Shaotang Li, Pan Chi, Huiming Lin, Xingrong Lu & Ying Huang

  2. Department of Colorectal and Anal Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, People’s Republic of China

    Shaotang Li

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  1. Shaotang Li
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Correspondence to Pan Chi.

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Li, S., Chi, P., Lin, H. et al. Long-term outcomes of laparoscopic surgery versus open resection for middle and lower rectal cancer: an NTCLES study. Surg Endosc 25, 3175–3182 (2011). https://doi.org/10.1007/s00464-011-1683-4

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  • DOI: https://doi.org/10.1007/s00464-011-1683-4

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