Short-term assessment of the safety and efficacy of laparoscopic versus open abdominoperineal resection for treatment of low rectal cancer: a prospective randomized trial

Background Laparoscopy has been widely applied for colorectal cancer surgery. Many studies have demonstrated that laparoscopy is safe and feasible for colon cancer. Recently, several studies compared laparoscopic abdominoperineal resection (LAPR) and open abdominoperineal resection for rectal cancer, but the results may differ from each other. This study was conducted to evaluate the safety and oncological efficacy of LAPR compared with the conventional open procedure. Setting Gastro-Intestinal Surgical Center, Mansoura University, Egypt. Patients and methods This is a prospective randomized trial conducted in the period between January 2017 and March 2019. A total of 60 patients diagnosed with low rectal cancers were included in this study. Patients were randomly allocated into two groups: group A included 30 cases who underwent the open procedure, and group B included the other 30 cases who underwent the laparoscopic technique. Both groups were compared in terms of operative time, blood loss, pain control, hospital stay, as well as early and late complications. Results Our data showed that LAPR resulted in early return to bowel functions expressed as early nasogastric tube removal, oral intake, flatus passage, and less postoperative pain. Moreover, LAPR is associated with fewer postoperative complications, especially abdominal wound infections and paralytic ileus. Conclusion LAPR is a safe and feasible procedure that reduces postoperative complications and leads to faster postoperative recovery, lesser use of analgesia, and shorter hospital stay. In addition, LAPR is not inferior to open abdominoperineal resection in terms of oncological clearance as it offers better chance for harvesting more dissected lymph nodes.