Purpose: To investigate the perioperative clinicopathologic outcome and postoperative survival of sphincter-sparing surgery by laparoscopic and open approach for patients with rectal cancer. Μethods: From January 1, 2008 to December 31, 2011, laparoscopic sphincter-sparing surgery and open sphincter-sparing surgery was performed in 228 patients with rectal cancer who were included in this study as open group (N=112) and laparoscopic group (N=116), respectively. The average follow-up time was approximately 5 years.
Results: Spearman's test showed that there was a slight negative correlation in overall survival and American Society of Anesthesiologists (ASA) grade (Spearman's r=-0.146, p=0.028), History of abdominal surgery (Spearman's r=-0.134, p=0.044) of all patients was statistically significant. There was no significant difference in survival between laparoscopic and open group (p=0.988). Kaplan-Meier curves showed that the total overall survival rates after laparoscopic and open sphincter-sparing surgery were similar in both groups. Log rank test showed that there were significant differences in overall survival among different ypTNM stages (pathological TNM after neoadjuvant chemotherapy) (p=0.002) and Charlson comorbidity index (p=0.03).
Conclusions: Compared with open approach, laparoscopic sphincter-sparing surgery of rectal cancer had less intraoperative bleeding, less postoperative complications and faster recovery of intestinal function after operation. Survival of open surgery and laparoscopic rectal sphincter preservation surgery was similar in both groups. ypTNM stage and Charlson comorbidity index are the risk factors affecting the survival of patients with rectal cancer.