Background: Trials have shown that laparoscopic resection is an acceptable alternative to open surgery for colon cancer. The role of laparoscopic resection in rectal cancer is unknown, as there are few long term data in consecutive series of patients.
Methods: Data were retrieved from a prospective database on 97 rectal cancer cases resected at our unit since it became our policy to attempt all operations laparoscopically in 1991, augmented by chart review and telephone survey. Results: 87 operations were completed laparoscopically (89.7%), and 83 patients had a curative resection. There was one anastomotic leak, but no peri-operative mortality. 33 patients had follow up data exceeding 3 years. The overall survival rate was 82.5% at 3 years, 62.5% at 5 years, and 50% at 10 years. There were 3 local recurrences following anterior resection and 1 following abdominoperineal resection (9.4% and 25.5% respectively), but there were no differences in overall survival (64.5% vs 59.5% at 5 years). Conclusion: Long term outcomes following laparoscopic TME are similar to those following open surgery, including converted cases. Local recurrence rates are lower following sphincter preservation. Laparoscopic surgery for rectal cancer is safe without compromise of oncological principles.
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