Long-term and Perioperative Outcomes of Laparoscopic and Open Surgery for Rectal Cancer

Objectives: The necessity of comparing oncologic results with the use of minimally invasive surgery in rectal cancer has arisen. The aim of the present study was to evaluate the treatment approach in rectal cancer and to compare the outcomes of laparoscopic and open surgery.
Methods: Patients who underwent surgery for rectal carcinoma between January 2006 and January 2016 in our institution were evaluated. The results were compared between the two groups according to open or laparoscopic surgery. Clinical characteristics, preoperative and postoperative results, pathological examination results, and disease-free survival rates were compared after the surgical procedure.
Results: A total of 121 patients were included in the study. Of the patients, 50 underwent open, and 71 underwent laparoscopic surgery. The median follow-up times were 56.75 months in the open surgery group and 55.2 months in the laparoscopic surgery group. Pathological examination revealed similar numbers of lymph nodes in both groups (p>0.05). The duration of hospital stay was statistically significantly lower in the open surgery group than in the laparoscopic group (p<0.05). The rates of disease-free survival were 74% in the open surgery group and 82.5% in the laparoscopic group, and no statistically significant difference was found (p>0.05).
Conclusion: There was no significant difference in complication and recurrence between laparoscopic and open surgery for rectal cancer in our study. The duration of hospital stay of patients was statistically significantly lower in the laparoscopic group than in the open surgery group. Laparoscopic or open surgical options could be preferred according to the clinical suitability of the patient, experience of the surgeon, and resources of the center in rectal cancer treatment.

Rektal kanser için laparoskopik ve açýk cerrahinin uzun süreli ve perioperatif sonuçlarý

Amaç: Rektum kanserinde minimal invaziv cerrahinin kullanýmý ile onkolojik sonuçlarýn karþýlaþtýrýlmasý gerekliliði ortaya çýkmýþtýr. Rektum kanserinde tedavi yaklaþýmýmýzý deðerlendirmek, laparoskopik ve açýk cerrahi sonuçlarýný karþýlaþtýrmayý amaçladýk.
Gereç ve Yöntem: Ocak 2006- Ocak 2016 yýllarý arasýnda kliniðimizde rektum karsinomu nedeniyle ameliyat edilen hastalar deðerlendirildi. Sonuçlar açýk ve laparoskopik cerrahi olarak iki grup arasýnda karþýlaþtýrýldý. Cerrahi giriþim sonrasý klinik özellikler, preoperatif ve postoperatif sonuçlar; patolojik inceleme sonuçlarý ve hastalýksýz saðkalým süreleri karþýlaþtýrýldý.
Bulgular: Çalýþmaya toplam 121 hasta dahil edildi. 50 hastaya açýk, 71 hastaya laparoskopik cerrahi uygulandý. Açýk cerrahi grubunda medyan takip süresi 56.75 ay; laparoskopik cerrahi grubunda hastalarýn medyan takip süresi 55.2 aydý. Patolojik incelemede her iki grupta benzer sayýda lenf nodu saptandý (p>0.05). Hastanede yatýþ süresi laparoskopik cerrahi grubunda açýk cerrahi grubuna göre istatistiksel olarak anlamlý derecede düþük bulundu (p<0.05). Hastalýksýz takip süresi açýk cerrahi grubunda %74, laparoskopik cerrahi grubunda %82.5’idi ve istatistiksel olarak anlamlý farklýlýk olmadýðý görüldü (p>0.05).
Sonuç: Çalýþmamýzda rektum karsinomu için laparoskopik ve açýk cerrahi arasýnda komplikasyon ve rekürrens açýsýndan anlamlý farklýlýk olmadýðý görüldü. Laparoskopik cerrahi grubunda bulunan hastalarýn hastanede kalýþ süresi açýk cerrahi grubundan istatistiksel olarak anlamlý derecede düþüktü. Laparoskopik veya açýk cerrahi seçenekleri, rektal kanser tedavisinde hastanýn klinik uygunluðuna, cerrahýn deneyimine ve merkez kaynaklarýna göre tercih edilebilir.