A comparative clinical study of short-term results of laparoscopic surgery for rectal cancer during the learning curve

Abstract

Objectives: The aim of this study was to assess the results of laparoscopic surgery for rectal carci- noma (LSRC) during the learning curve throughout the introduction of this technique at our medical center. Materials and methods: From January 2003 to April 2004, 40 pa- tients undergoing surgery were as- signed to laparoscopic surgery group (LSG) (n=20) or conventional surgery group (CSG) (n=20). Data were pro- spectively collected to statistically analyze clinical, anatomopathological, and economic variables. Results: Groups were comparable in age, sex, body mass index, American Society of Anesthesiologists score, surgical technique performed, tumor size and distance, Dukes’ stage, and proportion of patients with previous abdominal surgery and radiotherapy. There was no difference in operative time. LSG blood loss was lower (p<.0001). LSG peristalsis and oral intake began earlier (p<.0001). LSG hospital stay was shorter (p<.0001). Intraoperative complications (10% LSG vs 15% CSG) and overall morbidity (35% LSG vs 45% CSG) were no different. LSG did not record any anastomotic leakages. Two patients (10%) were converted to open surgery. Regarding oncologic adequacy of resection, specimen length and number of nodes harvested were no different. LSG distal and radial resection margins were greater (p<.0001; p=.03). LSG operative costs were greater (p<.0001). However, CSG hospital- ization costs were higher (p<.001). There was no overall difference (p=0.1). Conclusions: LSRC has been a reliable and efficient technique during the learning curve at our hospital.