Laparoscopic resection of extraperitoneal rectal cancer: a comparative analysis with open resection

The aim of this study was to compare the outcomes of laparoscopic surgery with those of open resection in patients with extraperitoneal rectal cancer. Five hundred forty-four patients with extraperitoneal rectal cancer who underwent curative resection between 1996 and 2007 were included. Patients were divided into a laparoscopic surgery group (LAP, n = 170) and an open surgery group (OPEN, n = 374). Morbidity requiring surgical correction was 5.8% in the LAP group and 4.8% in the OPEN group (p = 0.75). The anastomotic leakage rate was similar in both groups (5.7% in both; p = 0.98). Differences were found in preoperative carcinoembryonic antigen (CEA) (LAP group 4.6 ng/ml, OPEN group 7.7 ng/ml, p = 0.001), sphincter preservation (LAP group 82.9%, OPEN group 69.8%, p = 0.001), and mean distance from anal verge (LAP group 4.6 cm, OPEN group 5.2 cm, p = 0.002). Local recurrence and metastasis were similar by stage. The results of this study show that laparoscopic resection of extraperitoneal rectal cancer was safe and effective.