Retrospective study on the effect of laparoscopic and open total mesorectal excision for middle/low T3 rectal cancer

Objective: This study aimed to discuss the feasibility, safety, eradication effect, short-term outcomes, and midto long-term survival rates of laparoscopic total mesorectal excision (TME) in treating middle/low T3 rectal cancer. Methods: Patients with middle/low T3 rectal cancer that received an operation in our hospital from January 2009 to December 2012 were nonrandomly divided into laparoscopic and laparotomic groups. Comparative analysis was carried out to compare the clinical data and postoperative follow-up results of the two groups. Results: In the laparoscopic group, 85 cases were treated with laparoscopic TME without transfer to laparotomy. In the laparotomic group, 102 cases were treated with traditional TME. No significant difference was found between the two groups in average operation duration, resection range, postoperative complications, and length of hospital stay. However, the intraoperative blood loss and postoperative recovery of intestinal functions of the laparoscopic group were better. The median follow-up times for all cases, laparoscopic group, and laparotomic group were 23 (6-52), 21, and 24.5 months, respectively. The rates of local recurrence, distant metastasis, and tumor-free survival showed no significant difference between the two groups during the follow-up period. Conclusions: Laparoscopic TME can eradicate tumors with equal effect as laparotomic surgery and deserves to be popularized in clinical applications.