[Laparoscopic versus open intersphincteric resection for low rectal cancer: a clinical comparative study].

Objective: To compare the clinical and oncological outcomes between laparoscopic and open intersphincteric resection in patients with low rectal cancer.

Methods: From January 2007 to January 2010, patients with low rectal cancer treated by laparoscopic or open intersphincteric resection were included in a retrospective comparative study. Patients were classified into laparoscopy group (n=27) and open group (n=41). The operative procedures, postoperative complications, anal function and clinicopathological data were compared.

Results: Compared to the open group, the laparoscopic group had longer operative time [(242.2±42.5) min vs. (199.1±44.3) min, P=0.000], less blood loss [(150.5±102.2) ml vs. (258.4±149.2) ml, P=0.002], faster recovery of bowel function [(2.9±1.1) d vs. (3.6±1.5) d, P=0.032] and resumption of regular diet [(6.6±1.2) d vs. [(7.5±1.7) d, P=0.012], and shorter postoperative hospital stay [(7.7±1.4) d vs. (9.1±2.4) d, P=0.006]. The postoperative complication rate between the laparoscopic and open groups was not significantly different [18.5% (5/27) vs. 19.5% (8/41), P=0.464]. Oncological parameters were comparable between the two groups including lymph node harvested [(14.1±4.1) vs. (16.4±6.8), P=0.113], distal resection margin [(1.4±0.7) cm vs. (1.6±0.8) cm, P=0.311], and circumferential margin [7.4% (2/27) vs. 2.4% (1/41), P=0.709]. Local recurrence rates in laparoscopic and open groups were 7.4% (2/27) and 2.4% (1/41), and distant metastasis rates were 0 and 4.9% (2/41) respectively, and the differences were not significant (both P>0.05).

Conclusions: Laparoscopic intersphincteric resection possesses same efficacy of open intersphincteric resection with less blood loss, shorter recovery time and hospital stay, and similar oncological outcomes, and no increased postoperative morbidity and mortality.