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Purpose: The aim of this study was to assess the impact of laparoscopic vs. conventional open surgery for rectal cancer on clinical and oncologic outcome in a multi-modal setting. Methods: In total, 940 patients who underwent conventional open surgery between February 1995 and October 2007, and 311 patients who underwent laparoscopic surgery between December 2006 and May 2011 were enrolled retrospectively. Oncologic outcomes included 3-year overall survival (OS) and disease free survival, factors affecting them, and risk factors for local and systemic recurrence. Results: No difference was found between laparoscopic surgery and conventional open surgery in terms of OS, disease free survival rate at stages I and II, but the 3-year OS for stage III was different between the groups (70.26% for conventional open surgery vs. 90.14% for laparoscopic surgery; P=0.0002). The 3-year disease free survival rate for stage III was 56.59% for conventional open surgery vs. 56.65% for laparoscopic surgery (P=0.6578). The local recurrence rates were 6.81% vs. 8.47% (conventional open surgery vs. laparoscopic surgery; P=0.4960). The systemic recurrence rates were 15.64% vs. 15.71% (conventional open surgery vs. laparoscopic surgery; P=0.9713). Conclusion: Laparoscopic surgery for rectal cancer showed a similar short-term oncologic outcome to conventional open surgery. This suggests that laparoscopic surgery is an acceptable alternative to conventional open surgery for selected patients with rectal cancer.

Comparison of short-term oncologic outcomes following laparoscopic versus conventional open surgery for rectal cancer