Comparative Analysis on Short-term Efficacy of Laparoscopic versus Open Abdominal Perineal Resection for Rectal Cancer

Objective To explore the feasibility,safety and effectiveness of laparoscopy techniques applied in the abdominal perineal resection for rectal cancer. Methods The clinical data of 234 patients with abdominal perineal resection from Jan 2010 to Dec 2011 were analyzed retrospectively,including 98 patients underwent laparoscopic abdominal perineal resection (laparoscopic group),136 cases of open abdominal perineal resection (laparotomy group).The operation time,operative blood loss,time of first passing flatus,time of diet recovery,postoperative hospital stay,number of lymph nodes dissected and complicaton were evaluated using t test or chi-square test. Results Two groups of patients in age,sex and tumor stage,differentiation degree of the composition differences were not statistically significant.The mean operation time was (206.1±58.2)min in laparoscopic group,similar to (206.2±62.0)ml in open group(P=0.991).The mean operative blood loss was (188.7±151.5)ml in laparoscopic group and (296.3±274.3) ml in open group(P=0.014).The bowel movement was restored earlier in laparoscopic group than that in open group,and the diet recovery time and postoperative hospital stay time in the laparoscopic group were shorter than that in the laparotomy group(P<0.05).No significant differences were detected between two groups in tumor size,the distance of tumor from the anal verge,specimen length,or lymph node harvest(P>0.05).The overall complication rates were 4.0% and 14.7%( P=0.015). Conclusion Laparoscopic rectal abdominal perineal resection is less trauma,less bleeding after surgery and quicker recovery,and has no effect on the radical degree of the surgery.