Comparative Study On Perioperative Efficacy Of Resection Of Rectal Carcinoma By Laparoscopy Versus Open Approach

【Objective】To compare the perioperative efficacy of radical resection of rectal carcinoma by laparoscopy versus open approach. To investigate the feasibility , safety and oncological clearance of the laparoscopy surgery.【Methods】Clinical records of 44 patients who underwent radical resection of rectal carcinoma by laparoscopy from January 2004 to December 2007 in the second Affiliated Hospital of Guangzhou medical college were reviewed and compared with another 53 patients who underwent an open approach in the same period under the following parameters: surgical guidelines,postoperative recovery guidelines, tumor radical resection guidelines and postoperative complications. All the datas were analyzed by SPSS 13.0. There is no difference of statistical significance (P>0.05).【Results】A total of 97 patients were enrolled (44 in laparoscopy group and 53 in open group). The two groups were well balanced as to age, gender, staging and location of tumor. Histopathologically, the laparoscopic approach was equal to the open approach as regard to resection margin (distal margin, 3.2±1.2cm vs 3.4±1.1cm, P>0.05), lymph node yield (10.1±3.6 vs 11.3±6.9, P>0.05), post-operative stay (15.34±6.62d vs 16.82±5.73d, P>0.05) and demand of intra-operative blood transfusion (4case vs 8cases, P>0.05). This study also showed a longer surgical time (260.45±67.46min vs 179.25±40.92min, P <0.05), but less intra-operative blood loss (125.20ml±61.80 vs 198.02±131.24ml, P<0.05), and earlier recovery of bowel function of the laparoscopic group. There was no statistical difference of incidence of post-operative complications (4cases vs 10cases, P >0.05) between the two groups.【Conclusions】Comparing with open surgery,the radical resection of rectal carcinoma by laparoscopy has shown obvious advantages in smaller incision, less blood loss, less pain, earlier recovery of bowel and bladder functions, and earlier out-of-bed activity. Meanwhile, the laparoscopy approach is equal to the open approach on the oncological clearance. And there are possible advantages of less post-operative complications and reduced post-operative stay.