Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma

Background: Laparoscopic-assisted resection for colorectal lesions is feasi ble, but most reported series are heterogeneous and noncomparative. The aim of this study was to investigate whether laparoscopic-assisted resection w as better than open abdominoperineal resection for low rectal adenocarcinom a. Methods: Twenty-five (study group) of 59 consecutive patients who were cons idered suitable were selected for laparoscopic-assisted abdominoperineal re section based on the availability of informed consent, laparoscopic instrum ents, and experienced surgeons. The results in these patients were compared with the other 34 patients operated on by the open method (control group). Results: The median follow-up times for the study and control groups were 3 0.1 and 28.3 months, respectively. The operation time was significantly lon ger (t-test, p < 0.001), while operative blood loss (Mann-Whitney U test, p = 0.02), postoperative analgesic requirement (Mann-Whitney U test, p = 0.0 2), time to resume normal diet (Mann-Whitney U test, p = 0.04), and total h ospital stay (Mann-Whitney U test, p = 0.02) were significantly less in the study than in the control group. The oncological clearance, complication r ate, disease-free interval, and survival were comparable in the two groups. Conclusion: Laparoscopic-assisted abdominoperineal resection allowed earlie r postoperative recovery, with equal oncological clearance, morbidity, mort ality, disease-free interval, and survival.