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Comparison of long-term outcomes of laparoscopic and open sphincter-preserving total mesorectal excision for low rectal cancer.

PURPOSE
The purpose of this study was to compare the long-term outcomes of laparoscopic and open sphincter-preserving total mesorectal excision (TME) for low rectal cancer (LRC) using propensity score matching (PSM).


METHODS
The clinical and follow-up data of 169 patients with LRC who underwent sphincter-preserving TME at our institution between January 2011 and January 2014 were retrospectively analyzed. Patients were divided into laparoscopic and open group based on the surgical approach. PSM including age, sex, body mass index, clinical stage, and American Society of Anesthesiologists score with a 1:1 ratio was subsequently performed. Sixty-eight patients in each group were ultimately included, and short- and long-term outcomes were compared between groups.


RESULTS
Compared with the open group, the laparoscopic group had less intraoperative blood loss, more rapid postoperative recovery, and lower incidence of 30-day postoperative complications. However, there were no significant differences in severity of postoperative 30-day complications between the two groups. Both groups had no intraoperative or 30-day postoperative mortality. Regarding survival outcome, tumor recurrence rate, tumor recurrence site, 5-year overall survival, and 5-year disease-free survival, there were no significant differences between groups.


CONCLUSION
Laparoscopic sphincter-preserving TME can achieve long-term outcomes similar to those of open TME for LRC.