AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages Ⅱ and Ⅲ rectal cancer.METHODS:This study enrolled 406 consecutive patients who underwent curative resection for stagesⅡand...AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages Ⅱ and Ⅲ rectal cancer.METHODS:This study enrolled 406 consecutive patients who underwent curative resection for stagesⅡandⅢrectal cancer between January 2000 and December 2009[laparoscopic rectal resection(LRR),n=152;open rectal resection(ORR),n=254].Clinical characteristics,operative outcomes,pathological outcomes,postoperative recovery,and 5-year survival outcomes were compared between the two groups.RESULTS:Most of the clinical characteristics were similar except age(59 years vs 55 years,P=0.033)between the LRR group and ORR group.The proportion of anterior resection was higher in the LRR group than that in the ORR group(81.6%vs 66.1%,P=0.001).The LRR group had less estimated blood loss(50m L vs 200 m L,P<0.001)and a lower rate of blood transfusion(4.6%vs 11.8%,P=0.019)compared to the ORR group.The pathological outcomes of the two groups were comparable.The LRR group was associated with faster recovery of bowel function(2.8 d vs 3.7 d,P<0.001)and shorter postoperative hospital stay(11.7 d vs 13.7 d,P<0.001).The median followup time was 63 mo in the LRR group and 65 mo in the ORR group.As for the survival outcomes,the 5-year local recurrence rate(16.0%vs 16.4%,P=0.753),5-year disease-free survival(DFS)rate(63.0%vs63.1%,P=0.589),and 5-year overall survival(OS)rate(68.1%vs 63.5%,P=0.682)were comparable between the LRR group and the ORR group.Stageby stage,there were also no statistical differences between the LRR group and the ORR group in terms of the 5-year local recurrence rate(stageⅡ:6.3%vs 8.7%,P=0.623;stageⅢ:26.4%vs 23.2%,P=0.747),5-year DFS rate(stageⅡ:77.5%vs 77.6%,P=0.462;stageⅢ:46.5%vs 50.9%,P=0.738),and5-year OS rate(stageⅡ:81.4%vs 74.3%,P=0.242;stageⅢ:53.9%vs 54.1%,P=0.459).CONCLUSION:LRR for stagesⅡandⅢrectal cancer can yield comparable long-term survival while achieving short-term benefits compared to open surgery.展开更多
基金Supported by National Key Clinical Specialty Construction Project of China,the National High Technology Research and Development Program of China No.2012AA021103the Research Fund of Public Welfare in Health Industry,National Health and Family Planning Commission of China,No.201502039
文摘AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages Ⅱ and Ⅲ rectal cancer.METHODS:This study enrolled 406 consecutive patients who underwent curative resection for stagesⅡandⅢrectal cancer between January 2000 and December 2009[laparoscopic rectal resection(LRR),n=152;open rectal resection(ORR),n=254].Clinical characteristics,operative outcomes,pathological outcomes,postoperative recovery,and 5-year survival outcomes were compared between the two groups.RESULTS:Most of the clinical characteristics were similar except age(59 years vs 55 years,P=0.033)between the LRR group and ORR group.The proportion of anterior resection was higher in the LRR group than that in the ORR group(81.6%vs 66.1%,P=0.001).The LRR group had less estimated blood loss(50m L vs 200 m L,P<0.001)and a lower rate of blood transfusion(4.6%vs 11.8%,P=0.019)compared to the ORR group.The pathological outcomes of the two groups were comparable.The LRR group was associated with faster recovery of bowel function(2.8 d vs 3.7 d,P<0.001)and shorter postoperative hospital stay(11.7 d vs 13.7 d,P<0.001).The median followup time was 63 mo in the LRR group and 65 mo in the ORR group.As for the survival outcomes,the 5-year local recurrence rate(16.0%vs 16.4%,P=0.753),5-year disease-free survival(DFS)rate(63.0%vs63.1%,P=0.589),and 5-year overall survival(OS)rate(68.1%vs 63.5%,P=0.682)were comparable between the LRR group and the ORR group.Stageby stage,there were also no statistical differences between the LRR group and the ORR group in terms of the 5-year local recurrence rate(stageⅡ:6.3%vs 8.7%,P=0.623;stageⅢ:26.4%vs 23.2%,P=0.747),5-year DFS rate(stageⅡ:77.5%vs 77.6%,P=0.462;stageⅢ:46.5%vs 50.9%,P=0.738),and5-year OS rate(stageⅡ:81.4%vs 74.3%,P=0.242;stageⅢ:53.9%vs 54.1%,P=0.459).CONCLUSION:LRR for stagesⅡandⅢrectal cancer can yield comparable long-term survival while achieving short-term benefits compared to open surgery.
