Laparoscopic rectal cancer surgery: Where do we stand?

Table 1 Patient characteristics from randomized control trials

Ref.	Patients			M/F		BMI		Age (yr)		% Pre-op ChemoRT
	Total	Open	Lap	Open	Lap	Open	Lap	Open	Lap	Open	Lap
Kang et al[40]	340	170	170	110/60	110/60	24.1 (3.2)	24.1 (3.2)	59.1 (9.9)	57.8 (11.1)	100	100
Ng eet al[45]	153	77	76	48/29	37/39	NA	NA	65.7 (12)	66.5 (11.9)	NA	NA
Lujan et al[31]	204	103	101	64/39	62/39	NA	NA	66.0 (9.9)	67.8 (12.9)	74.8	72.3
Ng et al[39]	99	48	51	30/18	31/20	NA	NA	63.5 (12.6)	63.7 (11.8)	0	0
Guillou et al[7]/Jayne et al[12]	343	113	230	NA	NA	26 (4)	25 (4)	69 (12)	69 (11)	NA	NA
Braga et al[38]	168	85	83	64/21	55/28	NA	NA	65.3 (10.3)	62.8 (12.6)	14.1	16.9
Zhou et al[35]	171	89	82	43/46	46/36	NA	NA	45 (30-81)	44 (26-85)	NA	NA
Araujo et al[34]	28	15	13	10/5	9/4	25.6 (17.1-38.5)	23.5 (21.7-24.6)	56.4 (24-78)	59.1 (31-75)	15 (100%)	13 (100%)

BMI: Body mass index; ChemoRT: Chemoradiation.

Table 2 Intraoperative characteristics of patients from randomized control trials

Ref.	Number of patients (%)							Conv %	Op time (min)		Blood loss (mL)		Length of incision (cm)
	Total	Open			Lap				Open	Lap	Open	Lap	Open	Lap
		Total	LAR	APR	Total	LAR	APR
Kang et al[40]	340	170	146 (75.9)	24 (14.1)	170	151 (88.8)	19 (11.2)	1.2	197.0 (62.9)	244.9 (75.4)a	217.5 (150.0-400.0)	200.0 (100.0-300.0)a	20.0 (18.0-23.0)	5.0 (4.5-6.0)
Ng et al[45]	153	77	77 (100)	0 (0)	76	76 (100)	0 (0)	30.3	154.0 (70.3)	213.1 (59.3)a	337.3 (0-2542)	280.0 (0-3000)	NA	NS
Lujan et al[31]	204	103	81 (78.6)	22 (21.4)	101	77 (76.2)	24 (23.8)	7.9	172.9 (59.4)	193.7 (45.1)a	234.2 (± 174.3)	127.8 (± 113.3)a	NA	NA
Ng et al[39]	99	48	0 (0)	48 (100)	51	0 (0)	51 (100)	9.8	163.7 (43.4)	213.5 (46.2)a	555.6 (0-4720)	321.7 (0-3000)
Guillou et al[7]/Jayne et al[12]	343	113	79 (69.9)	34 (30.1)	230	167 (72.6)	63 (27.4)	34	180 135-220)	135 (100-180)	NA	NA	22 (18-29)	10 (6-17)
Braga et al[38]	168	85	74 (87.1)	11 (12.9)	83	76 (92)	7 (84)	7.2	209 (72)	262 (72)a	396 (50-1600)	213 (50-1600)a	19.1 (± 3.1)	5.8 ( 0.8)a
Zhou et al[35]	171	89	89 (100)	0 (0)	82	82 (100)	0 (0)	NA	106 (80-230)	120 (110-220)a	92 (50-200)	20 (5-120)a	NA	NA
Araujo et al[34]	28	15	0 (0)	15 (100)	13	0 (0)	13 (100)	0	284	228a	NA	NA	NA	NA

Conv: Conversion rate; LAR: Low anterior resection; APR: Abdominoperineal resection; NA: Not available.

^aP < 0.05 vs Open.

Table 3 Short-term oncologic outcomes of patients from randomized control trials

Ref.	LN		Positive margin (CRM/distal) (%)
	Open	Lap	Open	Lap
Kang et al[40]	18 (13-24)	17 (12-22)	7 (4.1)/NA	5 (2.9)/NA
Ng eet al[45]	12 (7)	11.5 (7.9)	1 (1.3)/NA	2 (2.6)/NA
Lujan et al[31]	11.57 (5.10)	13.63 (6.26)a	3 (2.9)/0	4 (4.0)/0
Ng et al[39]	13.0 (7)	12.4 (6.7)	2 (4.2)/NA	3 (5.9)/NA
Guillou et al[7]/Jayne et al[12]	NA	NA	(14)/NA	(16)/NA
Braga et al[38]	13.6 (6.9)	12.7 (7.3)	2 (2.4)/0	1 (1.2)/0
Zhou et al[35]	NA	NA	NA	NA
Araujo et al[34]	11.9	5.5a	NA	NA

LN: Lymph nodes; CRM: Circumferential resection margin; NA: Not available.

^aP < 0.05 vs Open.

Table 4 Short-term outcomes of patients in randomized control trial

Ref.	Length of stay (d)		Anastomotic leak (%)		Wound infection (%)		Ileus (%)		Pain/PCA use (mg) or (number of shots)		Mortality
	Open	Lap	Open	Lap	Open	Lap	Open	Lap	Open	Lap	Open	Lap
Kang et al[40]	9 (8-12)	8 (7-12)	0	2 (1.2)	11 (6.5)	2 (1.2)a	22 (12.9)	17 (10)	156.9 (117.0-185.2)	107.2 (80.0-150.0)	0	0
Ng eet al[45]	10.0 (3-39)	8.4 (2-32)a	4 (5.2)	1 (1.3)	9 (11.7)	5 (6.6)	2 (2.6)	1 (1.3)	8.3 (0-49)	4.9 (0-23)a	3 (3.9)	2 (2.6)
Lujan et al[31]	9.9 (6.8)	8.2 (7.3)	10 (12)	5 (6)	2 (1.9)	0 (0)	8 (7.8)	6 (5.9)	NA	NA	3 (2.9)	2 (1.9)
Ng et al[39]	11.5 (5-38)	10.8 (5-27)	NA	NA	4 (8.3)	0 (0)	2 (4.2)	1 (2.0)	11.4 (0-49)	6.0 (0-47)a	1 (2.8)	1 (2.5)
Guillou et al[7]/Jayne et al[12]	13 (9-18)	11 (9-15)	9 (7)	26 (10)	15 (12)	33 (13)	NA	NA	NA	NA	NA	NA
Braga et al[38]	13.6 (6-80)	10 (6-27)a	9 (10.6)	8 (9.6)	13 (15.3)	6 (7.2)	2 (2.3)	2 (2.4)	NA	NA	1 (1.2)	1 (1.2)
Zhou et al[35]	13.3 (3.4)	8.1 (3.1)a	3 (3.4)	1 (1.2)	NA	NA	NA	NA	NA	NA	0 (0)	0 (0)
Araujo et al[34]	< 10.5	10.5	NA	NA	NA	NA	NA	NA	NA	NA

PCA: Patient controlled analgesia; NA: Not available.

^aP < 0.05 vs Open.

Table 5 Long-term oncologic outcomes of patients in randomized control trials

Ref.	Mean F/U (mo)		LR (%)		DFS (%)		OS (%)
	Open	Lap	Open	Lap	Open	Lap	Open	Lap
Kang et al[40]	NA	NA	NA	NA	NA	NA	NA	NA
Ng eet al[45]	108.8 (69.8-168.7)	112.5 (71.1-168.3)	7.1	4.9	80.4 (5.1)	82.9 (4.9)	55.1 (6.5)	63.9 (6.6)
Lujan et al[31]	34.1 (20)	32.8 (18.9)	5.3	4.8	81	84.8	75.3	42.1
Ng et al[39]	90.1 (27.0-145.5)	87.2 (22.8-150.0)	11.1	5	73.6 (8.1)	78.1 (6.9)	76.5 (7.3)	75.2 (7.2)
Guillou et al[7]/Jayne et al[12]	36.8 (20.0-61.5)	36.8 (20.0-61.5)	10.1	9.7	70.4/46.9	70.9/49.8	66.7/57.7	74.6/65.2
Braga et al[38]	53.6	53.6	5.2	4	NA	NA	NA	NA
Zhou et al[35]	1.0-16.0	1.0-16.0	NA	NA	NA	NA	NA	NA
Araujo et al[34]	47.2	47.2	13.3	0	NA	NA	NA	NA

F/U: Follow-up; LR: Local recurrence; DFS: Disease-free survival; OS: Overall survival; NA: Not available.