Laparoscopic versus open rectal resection: a 1:2 propensity score–matched analysis of oncological adequateness, short- and long-term outcomes

Abstract

Background Laparoscopic resections for rectal cancer are routinely performed in high-volume centres. Despite short-term advantages have been demonstrated, the oncological outcomes are still debated. The aim of this study was to compare the oncological adequateness of the surgical specimen and the long-term outcomes between open (ORR) and laparoscopic (LRR) rectal resections. Methods Patients undergoing laparoscopic or open rectal resections from January 1, 2013, to December 31, 2019, were enrolled. A 1:2 propensity score matching was performed according to age, sex, BMI, ASA score, comorbidities, distance from the anal verge, and clinical T and N stage. Results Ninety-eight ORR were matched to 50 LRR. No differences were observed in terms of operative time (224.9 min. vs. 230.7; p = 0.567) and postoperative morbidity (18.6% vs. 20.8%; p = 0.744). LRR group had a significantly earlier soft oral intake (p < 0.001), first bowel movement (p < 0.001), and shorter hospital stay (p < 0.001). Oncological adequateness was achieved in 85 (86.7%) open and 44 (88.0%) laparoscopic resections (p = 0.772). Clearance of the distal (99.0% vs. 100%; p = 0.474) and radial margins (91.8 vs. 90.0%, p = 0.709), and mesorectal integrity (94.9% vs. 98.0%, p = 0.365) were comparable between groups. No differences in local recurrence (6.1% vs.4.0%, p = 0.589), 3-year overall survival (82.9% vs. 91.4%, p = 0.276), and disease-free survival (73.1% vs. 74.3%, p = 0.817) were observed. Conclusions LRR is associated with good postoperative results, safe oncological adequateness of the surgical specimen, and comparable survivals to open surgery.

Laparoscopic versus Open Surgery for Gastric Cancer in Western Countries: A Systematic Review and Meta-Analysis of Short- and Long-Term Outcomes

“…When the HRs and 95% CI were not provided in the studies, two authors (AC and EMM), following well-established methodologies, extracted data from Kaplan-Meier (KM) curves with GraphClick software 3.0 for Mac (Arizona-Software, Phoenix, AZ, USA) and estimated the HRs using an on-line calculator (https://www.gigacalculator.com/calculators/hazard-ratio-calculator.php, accessed on 15 April 2022). The method was validated with a blind approach by correlating the data extracted from our previously published KM curves [28][29][30] with the original data or by comparing the HR of the same study reported in other meta-analyses [31]. The HR was converted to logHR and SE with variance.…”

Comparison of Oncological Outcomes After Colorectal Cancer Surgery in Patients Undergoing Laparoscopic Versus an Open Procedure

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Robotic Colorectal Cancer Surgery. How to Reach Expertise? A Single Surgeon-Experience

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