Comparision Of Surgical Complication Rate Between Laparoscopic And Open Radical Resection For Mid-Low Rectal Cancer Following Neoadjuvant Chemoradiotherapy

Purpose: To compare the surgical complication rate between laparoscopic and open radical resection for mid-low rectal cancer following neoadjuvant chemoradiotherapy (NeoCRT).Methods:A retrospective analysis was conducted among 65 patients with locally advanced mid-low rectal cancer (Clinical staging:T_3⁴,N₀M₀ and T_1⁴,N_1-2M0who received neoadjuvant chemoradiotherapy from March 2003 to August 2010. Among them 5 cases who were converted to open surgery were removed, thirty-two cases received laparoscopic total mesorectal excision (TME) after neoadjuvant chemoradiotherapy (laparoscopic group, LP group) and twenty-eight cases received open operation (open group, OP group). The clinical data and surgical data of the two groups of patients were compared.Results: The two groups were comparable in the operative time, lymph node yield, positive surgical margins, and occurrence of intra-operative complications. The intra-operative blood loss, intestinal function recovery, days of postoperative hospitalization etc. is significantly better in LP group than that in OP group. The intra-operative complication rate was 3.1% in LP group and 3.6% in OP group(χ²=0.009; P>0.05). The overall postoperative complication rate was 12.5% in LP group and 35.7% in OP group(χ²=4.499; P<0.05),among which the complication rate of post-operative intestinal obstruction was 3.1% in LP group and 10.7% in OP group(χ²=0.382; P>0.05 ) ,when that of stoma leak was 13.3% and 16.7%(χ²=0.059;P>0.05)and that of pulmonary infection was 3.1% and 10.7%(χ²=1.382; P>0.05).There is incision infection in two cases in OP group.Conclusion:Laparoscopic radical resection for mid-low rectal cancer following neoadjuvant chemoradiotherapy can reduce intra-operative blood loss, promote the recovery of intestinal function and decrease days of postoperative hospitalization compare to open radical resection for mid-low rectal cancer following neoadjuvant chemoradiotherapy. There is no difference in intra-operative complication rate between LP and OP groups, but the post-operative complication rate is significantly lower in LP group than that in OP group.