A case-control-study comparing laparoscopic versus open surgery for rectosigmoidal and rectal cancer

This study compared laparoscopic with open surgery for the cure of cancer o f the rectosigmoid and rectum. Results of surgery, postoperative recovery, and oncological follow-up were compared between 32 laparoscopic curative pr ocedures (19 laparoscopic-assisted anterior resections for cancer of the re ctosigmoid or upper rectum and 13 laparoscopic abdominoperineal resections for low rectal cancer) and 32 controls matched for age, UICC stage, tumor s ite, and type of resection who underwent open surgery during the same obser vation period. Morbidity was identical after laparoscopic and open resectio n (31.3%). Surgery was equally radical in the two groups regarding yield of lymph nodes and lateral and distal margins. Survival, recurrence, and canc er-related mortality showed no statistical differences. There was no port-s ite recurrence. The benefits of laparoscopic surgery were shown with a redu ction in perioperative blood transfusion and earlier return of bowel functi on. However, the operative time was significantly increased in the laparosc opic,group. This study shows that laparoscopic surgery for the cure of colo rectal cancer is technically feasible, and that oncological short-term outc ome does not differ from the results achieved by open techniques. However, prospective randomized trials are mandatory to evaluate the definite role o f laparoscopic surgery for malignancy.