Laparoscopic surgery in rectal cancer: a retrospective analysis.

Background: Laparoscopic resection for the cure of rectal cancer is still a matter of debate. Laparoscopic approach is more complex and with a long learning curve, which may results in an increase in morbidity and mortality. This study aimed to retrospectively analyze the impact of laparoscopic resection for rectal cancer on operative outcome of a hospital in a developing country.

Methods: All patients presenting with rectal cancer surgically managed by laparoscopic approach were enrolled. Exclusion criteria were total coloproctectomy, palliative procedures, and metastatic disease. The following parameters were accessed: general characteristics, technical details, mortality, and the outcome.

Results: From January 2000 to January 2008, 60 patients with histologically proven rectal cancer were enrolled, and 43 were excluded. Mean age, 58.5 +/- 15.9 years. A 76.6% of patients had cancer-advanced stages. There were 20 anterior resections, 31 abdomino-perineal resections, and nine pull-through procedures. Conversion rate was 3.3%, and there had 3.3% of operative complications. No procedure-related death. With the mean follow-up of 33 months, 77.8% patients are alive and disease-free, 5.6% are alive with disease: distant metastasis in 2.8%, and local recurrence in 2.8%. About 16.7% have died from cancer-related causes. No port site or wound metastasis have occurred.

Conclusions: This study showed the favorable short-term operative results in patients who underwent laparoscopic resection for rectal cancer. The low conversion rate of 3.3%, 3.3% complication rate, and 0% of a 30-day mortality attributed to confirm the feasibility of laparoscopic approach in the surgical treatment of rectal cancer.