Comparison of the efficacy and complications of laparoscopic and open rectal resection for middle and low rectal cancer

doi:10.3877/cma.j.issn.1674-3946.2025.02.009.

Abstract

Abstract:

Objective

To compare the efficacy and complications of laparoscopic and open rectal resection for middle and low rectal cancer.

Methods

Data of 482 patients with low and middle rectal cancer admitted from January 2019 to January 2023 were retrospectively analyzed and divided into group A (n=245 patients undergoing laparoscopic rectal cancer resection) and group B (n=237 patients undergoing open rectal cancer resection) according to different operation methods.SPSS 24.0 was used to analyze the data.Normal measurement data were expressed as(x±s), and independent sample t test was performed for comparison between groups.The counting data［ e.g.(%)］ were indicated by χ² test.Rank data row Rank Sum test.P＜0.05 indicates statistical difference in data comparison.

Results

The operative time of group A was longer than that of group B, but the intraoperative blood loss, the first postoperative ventilation time and the length of hospital stay were lower than those of group B (P＜0.05).There was no significant difference in the number of lymph node dissection, the number of positive circumferential margin and postoperative clinical stage between the two groups (P＞0.05).The total incidence of postoperative complications in group A was 6.5%, lower than 12.2% in group B (P＜0.05).The local recurrence rate and survival rate were 12.7% and 97.6% in group A and 13.1%and 97.8% in group B, respectively, with no statistical significance (P＞0.05).

Conclusion

Laparoscopic and open rectal cancer resection have similar oncology effects and long-term curative effects in the treatment of middle and low rectal cancer.Compared with open surgery, laparoscopic surgery has the advantages of less trauma, faster postoperative recovery and higher safety.

Key words: Rectal Neoplasms, Laparoscopes, Laparotomy, Postoperative Complications

Lijun Zhou, Lu Wang, Qiao Lin. Comparison of the efficacy and complications of laparoscopic and open rectal resection for middle and low rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 146-148.

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URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2025.02.009.

https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2025/V19/I02/146

Figures/Tables 4

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	肿瘤与肛缘的距离（cm， $\overset{ˉ}{x}$ ±s）	性别（例）	肿瘤分化程度（例）
组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	肿瘤与肛缘的距离（cm， $\overset{ˉ}{x}$ ±s）	男/女	低分化/中分化/高分化
A组	245	57.4±7.1	3.2±0.3	6.2±1.3	132/113	86/81/78
B组	237	56.9±8.1	3.1±0.3	6.4±1.1	119/118	87/77/73
t/χ²值		0.721	1.114	1.820	0.469	0.376
P值		0.471	0.266	0.069	0.420	0.540

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	肿瘤与肛缘的距离（cm， $\overset{ˉ}{x}$ ±s）	性别（例）	肿瘤分化程度（例）
组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	肿瘤与肛缘的距离（cm， $\overset{ˉ}{x}$ ±s）	男/女	低分化/中分化/高分化
A组	245	57.4±7.1	3.2±0.3	6.2±1.3	132/113	86/81/78
B组	237	56.9±8.1	3.1±0.3	6.4±1.1	119/118	87/77/73
t/χ²值		0.721	1.114	1.820	0.469	0.376
P值		0.471	0.266	0.069	0.420	0.540

组别	例数	手术时间（min）	术中出血量（ml）	术后初次通气时间（d）	住院时间（d）
A组	245	186.7±20.4	91.4±15.7	3.2±0.8	9.4±1.7
B组	237	135.3±17.6	157.4±37.3	4.1±1.1	12.4±2.5
t值		29.576	25.463	10.297	15.450
P值		＜0.001	＜0.001	＜0.001	＜0.001

组别	例数	淋巴结清扫数目（枚， $\overset{ˉ}{x}$ ±s）	环周切缘阳性数（例）	术后临床分期（例）
组别	例数	淋巴结清扫数目（枚， $\overset{ˉ}{x}$ ±s）	环周切缘阳性数（例）	Ⅰ期/	Ⅱ期/	Ⅲ期
A组	245	14.9±2.4	2	65/	108/	72
B组	237	14.6±2.1	5	68/	99/	70
t/χ²值		1.459	1.408	0.288
P值		0.145	0.235	0.774

组别	例数	淋巴结清扫数目（枚， $\overset{ˉ}{x}$ ±s）	环周切缘阳性数（例）	术后临床分期（例）
组别	例数	淋巴结清扫数目（枚， $\overset{ˉ}{x}$ ±s）	环周切缘阳性数（例）	Ⅰ期/	Ⅱ期/	Ⅲ期
A组	245	14.9±2.4	2	65/	108/	72
B组	237	14.6±2.1	5	68/	99/	70
t/χ²值		1.459	1.408	0.288
P值		0.145	0.235	0.774

组别	例数	切口感染	肠梗阻	排尿困难	吻合口漏	肺部感染	总并发症
A组	245	4(1.6)	2(0.8)	6(2.5)	2(0.8)	2(0.8)	16(6.5)
B组	237	9(3.8)	4(1.7)	8(3.4)	4(1.7)	4(1.7)	29(12.2)
χ ²值		-	-	-	-	-	4.633
P值		-	-	-	-	-	0.031

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