The Comparative Analysis Of Short-term Outcomes,Prognosis And Quality Of Life Following Laparoscopic And Open Radical Resection Of Rectal Cancer

Objective To investigate the short-term curative effect,prognosis and quality of life after laparoscopic radical resection of rectal cancer.Materials and methods Retrospective analysis of 99 patients who underwent radical resection of rectal cancer from January 2013 to January 2015 in the First Affiliated Hospital of Xiamen University,Department of Gastrointestinal Surgery.And there were 67 cases in the laparoscopic-surgery group,including 16 cases of laparoscopic abdominoperineal resection and 51 cases of laparoscopic anterior resection.And 32 cases in the open-surgery group,including 9 cases of open abdominoperineal resection and 23 cases of open anterior resection.Analysis of two groups of patients in the perioperative indicators,postoperative overall survival rate and quality of life(QOL).Results By comparing the clinical data of patients in two groups,there was no significant difference in the age,gender,body mass index(BMI),operating type,tumor stage and distance of tumor from anal verge,indicating that the data of the two groups were comparable.Compared to open-surgery group,the laparoscopic-surgery group had less intraoperative blood loss(122.54±81.55 ml vs 164.69±95.92 ml,P < 0.05),shorter time to first flatus(2.33±2.03 day vs 3.69±1.93 day,P<0.05),shorter hospital stay(14.51±6.69 day vs 18.25±9.74 day,P<0.05)and less postoperative complications(13.43% vs 31.25%,P<0.05).However,the operating time(155.60±48.60 min vs 161.88±50.80min),proportion of preventive colostomy(37.25% vs 34.78%),the number of lymph nodes harvested(21.37±7.27 vs 19.97±6.91)and distal resection margins(2.68±0.90 cm vs 2.59±0.80cm)was similar between the two groups(P>0.05).As for survival rate,1 and 3 years overall survival rate were similar in two groups(92.54% vs 90.63%,P>0.05 and 73.58% vs 81.25%,P>0.05,respectively).In addition,we evaluated the postoperative quality of life,finding that there was no significant difference between the two groups at 3 months postoperatively(P>0.05).Conclusion Laparoscopic surgery is safe for radical resection of rectal cancer.Compared to open surgery,laparoscopic surgery has the advantages of less intraoperative blood loss and postoperative complications,shorter recovery time.In the same time,laparoscopic surgery can achieve similar postoperative overall survival rate and quality of life as open surgery.