Laparoscopic versus Open Rectosigmoid Cancer Resection: A comparative Study

Document Type : Original Article

Authors

1 Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

2 Department of Vascular Surgery; Damietta Faculty of Medicine, Al-Azhar University, Egypt

3 Department of Public Health, Faculty of Medicine, Cairo University, Egypt

Abstract

Background: Although widely performed the usefulness of Laparoscopic surgery for rectosigmoid and upper rectal cancer resection compared with open surgery has not been established sufficiently.  
The aim of this study was to compare the short-term, oncologic, outcomes of laparoscopic and open resection for recto-sigmoid and / or upper rectal cancer in the same time period.
Patients and Methods: This prospective study included 50 patients with recto- sigmoid and upper rectal cancer diseases, admitted to Al Azhar New Damietta University hospital and Damietta cancer Institute surgery departments between December 2016 and December 2018. Patients were randomly divided into two groups: [Group 1: "25 patients"] subjected to laparoscopic interventions, and [Group 2: "25 patients]" subjected to open surgery. Data were collected and Short-term outcomes and long-term prognosis were analyzed.
Results: The mean operative time was significantly increased in the LR group than OR group [LR 198.88± 18.7, OR 183.4± 20.5 minutes, p =0.01] as well as the hospital stay [LR 8.8± 2, OR 7.4± 2.9 days, p =0.013]. However, LR group was quicker to recover in term of mobilizing early, recovery of bowel function, and early toleration of diet and fluid and this difference was only statistically significant for oral fluid but not for diet [p= 0.078; 0.17 respectively]. There was no significant difference between both groups in tumor characteristics as locations, gross tumor morphology, staging, and distance to the distal margin. Also, both groups had comparable intraoperative and post-operative adverse events.
Conclusion: Laparoscopic surgery for rectosigmoid cancer and rectal cancer offers numerous advantages beyond aesthetics aspects and is possible and safe with comparable oncological clearance to open surgery and might be considered an option of care when both approaches are suitable.

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