Pathological outcomes in rectal cancer following laparoscopic surgery

Aim: This study examined pathological quality-of-surgery indicators in laparoscopic and open rectal cancer resection specimens. Methods: Retrospective analysis of consecutive, prospectively recorded laparoscopic (LR) or open (OR) resections for rectal cancer. Indicators included integrity of the perirectal fascial envelope, circumferential margin clearance, lymph node yield and distal margin clearance. Results: Between January 2007 and December 2013, 168 LR and 189 OR were performed. Univariate analysis showed that the presence of tumor within 1 mm of the circumferential margin was lower in LR (13/168 vs 28/189 cases, P = 0.039) as was a distal margin of clearance of < 1 cm (3/165 vs 12/186, P = 0.032). There was no difference in the surgical disruption of the fascial envelope (P = 0.091) or the percentage of specimens with a lymph node yield < 12 (P = 0.576) between the LR and OR groups. Multivariate analysis did not reveal any significant differences in pathological outcomes. Conclusion: With careful case selection, laparoscopic surgery has similar pathological outcomes to open surgery for rectal cancer.