Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2025
Short- and long-term outcomes of laparoscopic versus open abdominoperineal resection for rectal cancer: A propensity score matching analysis based on 1852 cases.
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Zhu Zixing, Quan Jichuan, Jiang Dedi, Bi Jianjun, Feng Qiang, Pei Wei, Zhou Haitao, Zheng Zhaoxu, Liu Qian, Zhao Zhixun, Liang Jianwei
Аннотация
BACKGROUND: Randomized studies have demonstrated that laparoscopic abdominoperineal resection is not inferior to open abdominoperineal resection for rectal cancer.
AIMS: Evaluate the immediate and extended results of laparoscopic abdominoperineal resection versus open abdominoperineal resection for rectal cancer.
METHODS: From January 2006 to December 2017, a total of 1852 patients with rectal cancer who had undergone abdominoperineal resection were enrolled in this investigation. The groups were matched in a 1:1 ratio using propensity score matching. The primary endpoints were overall survival and disease-free survival. The secondary endpoints were pathology and short-term postoperative outcomes.
RESULTS: Compared to the open abdominoperineal resection group, the laparoscopic abdominoperineal resection group exhibited a higher rate of positive circumferential resection margins (P < 0.001) and fewer postoperative complications (P < 0.001). 5-year disease-free survival (P = 0.449) and overall survival rates (P = 0.664) were comparable. Age (P < 0.001), comorbidity (P = 0.040), (y)pT (P = 0.024), (y)pN (P < 0.001), lymphovascular invasion (P = 0.003) and positive circumferential resection margins (P = 0.014) were independent prognostic risks for overall survival.
CONCLUSION: The pathological outcomes of laparoscopic abdominoperineal resection are inferior compared to open abdominoperineal resection. However, they demonstrate comparable long-term oncological outcomes, and laparoscopic abdominoperineal resection offers certain short-term advantages over the open approach.
AIMS: Evaluate the immediate and extended results of laparoscopic abdominoperineal resection versus open abdominoperineal resection for rectal cancer.
METHODS: From January 2006 to December 2017, a total of 1852 patients with rectal cancer who had undergone abdominoperineal resection were enrolled in this investigation. The groups were matched in a 1:1 ratio using propensity score matching. The primary endpoints were overall survival and disease-free survival. The secondary endpoints were pathology and short-term postoperative outcomes.
RESULTS: Compared to the open abdominoperineal resection group, the laparoscopic abdominoperineal resection group exhibited a higher rate of positive circumferential resection margins (P < 0.001) and fewer postoperative complications (P < 0.001). 5-year disease-free survival (P = 0.449) and overall survival rates (P = 0.664) were comparable. Age (P < 0.001), comorbidity (P = 0.040), (y)pT (P = 0.024), (y)pN (P < 0.001), lymphovascular invasion (P = 0.003) and positive circumferential resection margins (P = 0.014) were independent prognostic risks for overall survival.
CONCLUSION: The pathological outcomes of laparoscopic abdominoperineal resection are inferior compared to open abdominoperineal resection. However, they demonstrate comparable long-term oncological outcomes, and laparoscopic abdominoperineal resection offers certain short-term advantages over the open approach.