Laparoscopic assisted versus open abdominoperineal resection for low rectal adenocarcinoma: A comparison in respect of postoperative recovery and complications

Background: there are various studies delineates that laparoscopic colonic surgery have less postoperative pain,after surgery rapid recovery,shorter hospital stay,and quick resumption of daily activity when compared to open surgery. but there are only few studies comparing the laparoscopic assisted to open abdominoperineal resection for low rectal or anal canal caners. aim: to evaluate and compare the results of laparoscopic assisted and open abdominoperineal resection (lap-apr and open-apr) for low rectal cancer. methods: between 20th november 2008 to 10th september 2012,82 patients were underwent surgery for low rectal adenocarcinoma,among them 37 patients underwent laparoscopic assisted apr,and 45 patients were underwent open apr. the operative outcomes and postoperative complications of these two groups were compared. results: there were no significant differences between lap-apr and open-apr in patient's age and tumour stage. post-operative recovery was better in lap-apr group,with earlier return of bowel function ('p' value= 0.0001),time to take water ('p'= 0.0001),time to take soft diet ('p'= 0.0035) and early mobilization ('p'= 0.0034),all these are more significant. but the operative time was longer in lap-apr ('p'= 0.020). perineal wound morbidity were same in both groups,but the abdominal wound infection rate was higher in open-apr ('p'=0.0209),as lap-apr devoid of long laparotomy wound,it only have small trocar wounds. two year survival was nearly same in both groups. conclusion: lap=apr have advantages over open-apr in rapid postoperative recovery of bowel function,early oral intake,and early mobilization. but lap-apr has longer operative time.