Comparing laparoscopic versus open surgery for patients with rectal cancer.

The aim of this study was to compare the outcome of laparoscopic (keyhole surgery) and open surgery for patients with rectal cancer. The study found no difference in patient outcomes between laparoscopic and open surgery groups.

Localized rectal cancer can be treated by surgical removal of the tumor. Usually, patients receive chemotherapy before surgery to shrink the tumor. Complete removal of the tumor is called total mesorectal excision (TME). 

There are different types of surgery to remove the rectal tumor. Laparoscopic surgery (LS) involves a surgeon removing the tumor using a camera to guide them through small incisions. Open surgery (OS) involves a larger incision in the abdomen to remove the tumor. LS has been shown to have fewer complications and faster healing compared to OS. However, different studies have shown that it may not be associated with the same oncological benefit as OS. Therefore, it is important to review which type of surgery gives the best patient outcome.

This study evaluated data from 3744 patients in 12 clinical trials.  2133 (57%) patients had LS. 1611 (43%) patients had OS.

There was no significant difference in patient survival between groups. The survival rates after 2 years were 89.2% in the LS group and 91.3% in the OS group. At 5 years, survival rates were 77.3% in the LS group and 81% in the OS group.

Recurrence was evaluated in 9 trials. Patients who had LS had a similar rate of local recurrence (4.4%) as the OS group (4.3%). Recurrence in distant organs or tissues was also similar in the LS group (17.2%) and the OS group (18.5%).

The study found that if the rectal cancer surgery is performed well, there is no difference in patient outcome between LS or OS.

This study included multiple studies with different protocols. The patients had different cancer stages and tumor sizes. This might have affected results.