[Outcomes following rectal and recto-sigmoid cancer resections: comparison of the laparoscopic and open techniques]. / Rectum- és rectosigmoidealis tumorresectiók eredményei: a laparoscopos és nyitott technika összehasonlítása.

ABSTRACT

BACKGROUND/AIMS: Surgical technique and experience are considered as significant determinants of the successful treatment of recto-sigmoid malignancies. METHODS: Two hundred patients operated on between 2005 and 2009 were prospectively followed with an average of 39.8 months. Patients with rectosigmoid or rectal cancer were included, either with primary resection or resection after neoadjuvant therapy. The primary aim was to assess the average survival in the two groups; secondary outcomes were stage specific survival and the incidence of loco-regional recurrence and distant metastases. Intra- and postoperative complications, operating time, onco-pathological specimen quality and length of stay were also analysed. RESULTS: During the follow-up comparable rates for 3-year survival and recurrence rates were found without statistical difference. Hospital stay in the laparoscopic group was significantly shorter and the mid-term survival rates were also better in the more advanced stages. Incisional hernia rate was significantly lower in the laparoscopic group. CONCLUSIONS: The results of laparoscopic rectal and recto-sigmoid resections were not inferior, and - in some aspects - they were even better compared to open procedures. Adding the properties of the minimally invasive technique (shorter recovery, reduced surgical stress reaction) this should be the preferred method of operative approach.