Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2015; 21(48): 13532-13541
Published online Dec 28, 2015. doi: 10.3748/wjg.v21.i48.13532
Clinical comparison of laparoscopy vs open surgery in a radical operation for rectal cancer: A retrospective case-control study
Chen Huang, Jia-Cheng Shen, Jing Zhang, Tao Jiang, Wei-Dong Wu, Jun Cao, Ke-Jian Huang, Zheng-Jun Qiu
Chen Huang, Jing Zhang, Tao Jiang, Wei-Dong Wu, Jun Cao, Ke-Jian Huang, Zheng-Jun Qiu, Department of General Surgery, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
Jia-Cheng Shen, Department of General Surgery, Yancheng Third People’s Hospital, The affiliated Yancheng hospital of Southeast University Medical College, Yancheng 224001, Jiangsu Province, China
Author contributions: Huang C, Shen JC, Zhang J and Jiang T contributed equally to this paper; Huang C designed and performed this research; Shen JC collected the data and contributed to the analysis; Zhang J contributed to the analysis and wrote the paper; Jiang T analyzed data and modified the paper; Wu WD, Cao J and Huang KJ provided clinical advice; Qiu ZJ designed and performed the research and supervised the report.
Supported by Grants from the Shanghai Municipal Human Resources and Social Security Bureau, No. 2012040 and No. 13PJD024 to Huang C; grant from the Shanghai Health and Family Planning Commission, No. XYQ2013092 to Huang C; and grant from Shanghai Municipal Science and Technology Commission, No. 14411966800 to Huang C.
Institutional review board statement: Our study was a retrospective case-control study between laparoscopic surgery and open surgery in rectal cancer. And the study was and approved by the Ethics Committee of Shanghai First People’s Hospital Affiliated Shanghai Jiao Tong University.
Conflict-of-interest statement: The authors declare that they have no conflict-of-interest and we have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Zheng-Jun Qiu, MD, Professor, Department of General Surgery, Shanghai First People’s Hospital, School of Medicine, Shanghai Jiao Tong University, 100 Haining Road, Shanghai 200080, China. richard-hc@sohu.com
Telephone: +86-21-63240090 Fax: +86-21-63240090-3121
Received: July 8, 2015
Peer-review started: July 8, 2015
First decision: August 26, 2015
Revised: September 6, 2015
Accepted: November 9, 2015
Article in press: November 9, 2015
Published online: December 28, 2015
Processing time: 169 Days and 1.3 Hours
Abstract

AIM: To assess the diverse immediate and long-term clinical outcomes, a retrospective comparison between laparoscopic and conventional operation was performed.

METHODS: A total number of 916 clinical cases, from January 2006 to December 2013 in our hospital, were analyzed which covered 492 patients underwent the laparoscopy in radical resection (LRR) and 424 cases in open radical resection (ORR). A retrospective analysis was proceeded by comparing the general information, surgery performance, pathologic data, postoperative recovery and complications as well as long-term survival to investigate the diversity of immediate and long-term clinical outcomes of laparoscopic radical operation.

RESULTS: There were no statistically significance differences between gender, age, height, weight, body mass index (BMI), tumor loci, tumor node metastasis stages, cell differentiation degree or American Society of Anesthesiologists scores of the patients (P > 0.05). In contrast to the ORR group, the LRR group experienced less operating time (P < 0.001), a lower blood loss (P < 0.001), and had a 2.44% probability of conversion to open surgery. Postoperative bowel function recovered more quickly, analgesic usage and the average hospital stay (P < 0.001) were reduced after LRR. Lymph node dissection during LRR appeared to be slightly more than in ORR (P = 0.338). There were no obvious differences in the lengths and margins (P = 0.182). And the occurrence rate in the two groups was similar (P = 0.081). Overall survival rate of ORR and LRR for 1, 3 and 5 years were 94.0% and 93.6% (P = 0.534), 78.1% and 80.9% (P = 0.284) and 75.2% and 77.0% (P = 0.416), respectively.

CONCLUSION: Laparoscopy as a radical operation for rectal cancer was safe, produced better immediate outcomes. Long-term survival of laparoscopy revealed that it was similar to the open operation.

Keywords: Laparoscopic; Open surgery; Short-term outcomes; Long-term outcomes; Rectal cancer

Core tip: This is a retrospective case-control study between laparoscopic surgery and open surgery in rectal cancer. There are 916 clinical cases, collecting from January 2006 to December 2013 in our hospital, which covered 492 cases in laparascopic group and 424 cases in open group. We compared the general information, surgery performance, pathologic data, postoperative recovery and complication as well as the long-term survival of the patients. And than we concluded that laparoscopy can produce better immediate outcomes in rectal cancers. And the long-term survival of laparoscopy was similar to the open operation.