Short-term and long-term outcomes of laparoscopic surgery for locally recurrent rectal cancer: a propensity score-matched cohort study

• Published in: Techniques in coloproctology 2024-12, Vol.28 (1), p.100, Article 100
• Main Authors: Zhang, Jinzhu, Huang, Fei, Niu, Ruilong, Mei, Shiwen, Quan, Jichuan, Hu, Gang, Li, Bo, Zhuang, Meng, Guo, Wei, Wang, Xishan, Tang, Jianqiang
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Blood Loss, Surgical - statistics & numerical data; Colorectal cancer; Colorectal Surgery; Female; Gastroenterology; Humans; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Laparoscopy - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - surgery; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Proctology; Propensity Score; Rectal Neoplasms - mortality; Rectal Neoplasms - surgery; Retrospective Studies; Surgery; Surgical outcomes; Surgical site infections; Surgical techniques; Survival analysis; Time Factors; Treatment Outcome
• ISSN: 1123-6337; 1128-045X; 1128-045X
• DOI: 10.1007/s10151-024-02977-5

Background Radical surgery remains the primary option for locally recurrent rectal cancer (LRRC) as it has the potential to considerably extend the patient’s lifespan. At present, the effectiveness of laparoscopic surgery for LRRC remains unclear. Methods The clinical data of patients with LRRC who were admitted to the Cancer Hospital of the Chinese Academy of Medical Sciences between 2015 and 2021 were retrospectively analyzed in this study. Patients were categorized into two groups, namely the open group and the laparoscopic group, based on the surgical method used. Propensity score matching was used to reduce baseline differences. The short-term outcomes and long-term survival between the two groups were compared. Results Curative surgery was performed on 111 patients who were diagnosed with LRRC. After propensity score matching, a total of 80 patients were included and divided into the laparoscopic group (40 patients) and the open group (40 patients). The laparoscopic group had less intraoperative bleeding (100 vs. 300, P  = 0.011), a lower postoperative complication rate (20.0% vs. 42.5%, P  = 0.030), a lower incidence of wound infection (0 vs. 15.0%, P  = 0.026), and a shorter time to first flatus (2 vs. 3, P  = 0.005). The laparoscopic group had higher 3-year overall survival (85.4% vs. 57.5%, P  = 0.016) and 3-year disease-free survival (63.9% vs 36.5%, P  = 0.029). Conclusions In comparison to open surgery, laparoscopic surgery is linked to less bleeding during the operation, quicker recovery after the surgery, and a lower incidence of infections at the surgical site. Moreover, laparoscopic surgery for LRRC might yield superior long-term survival outcomes.