BACKGROUND: Outcomes between laparoscopic (LAPR) and open abdominoperineal resections (OAPR) are poorly described. METHODS: After IRB approval, 2005-2008 NSQIP data were used to identify patients undergoing LAPR and OAPR for rectal cancer. Logistic regression identified variables influencing the selection of LAPR vs. OAPR as well as the likelihood of postoperative events. Chi-square analysis was used to compare the incidence of 30-day postoperative events. RESULTS: One thousand one hundred ninety-seven OAPRs and 143 LAPRs were identified. LAPRs were less likely to have a body mass index (BMI) of ≥30 (p = 0.04) and were associated with equivalent mean operative times (p = 0.36). LAPRs and OAPRs were found to have similar rates of surgical site infections (p = 0.13), transfusion requirements (p = 0.17), myocardial infarction (p = 0.48), and need for reoperation within 30 days (p = 0.20). Neoadjuvant radiotherapy did not directly increase complication rates in either group. Few factors predicted choice of LAPR but included BMI <25 (OR, 1.54; p = 0.02). CONCLUSION: Complication rates between LAPR and OAPR were similar despite the greater technical challenge of LAPR. Wound infection rates were equivalent, which may reflect similar rates of perineal wound infections. Few patients are offered LAPR, possibly due to surgeon preferance as opposed to patient factors.
BACKGROUND: Outcomes between laparoscopic (LAPR) and open abdominoperineal resections (OAPR) are poorly described. METHODS: After IRB approval, 2005-2008 NSQIP data were used to identify patients undergoing LAPR and OAPR for rectal cancer. Logistic regression identified variables influencing the selection of LAPR vs. OAPR as well as the likelihood of postoperative events. Chi-square analysis was used to compare the incidence of 30-day postoperative events. RESULTS: One thousand one hundred ninety-seven OAPRs and 143 LAPRs were identified. LAPRs were less likely to have a body mass index (BMI) of ≥30 (p = 0.04) and were associated with equivalent mean operative times (p = 0.36). LAPRs and OAPRs were found to have similar rates of surgical site infections (p = 0.13), transfusion requirements (p = 0.17), myocardial infarction (p = 0.48), and need for reoperation within 30 days (p = 0.20). Neoadjuvant radiotherapy did not directly increase complication rates in either group. Few factors predicted choice of LAPR but included BMI <25 (OR, 1.54; p = 0.02). CONCLUSION: Complication rates between LAPR and OAPR were similar despite the greater technical challenge of LAPR. Wound infection rates were equivalent, which may reflect similar rates of perineal wound infections. Few patients are offered LAPR, possibly due to surgeon preferance as opposed to patient factors.
Authors: Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy Journal: Lancet Oncol Date: 2005-07 Impact factor: 41.316
Authors: S Delgado; D Momblán; L Salvador; R Bravo; A Castells; A Ibarzabal; J M Piqué; A M Lacy Journal: Surg Endosc Date: 2004-08-26 Impact factor: 4.584
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: David G Jayne; Pierre J Guillou; Helen Thorpe; Philip Quirke; Joanne Copeland; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: J Clin Oncol Date: 2007-07-20 Impact factor: 44.544
Authors: Gabriela Batista Rodríguez; Andrea Balla; Santiago Corradetti; Carmen Martinez; Pilar Hernández; Jesús Bollo; Eduard M Targarona Journal: Int J Colorectal Dis Date: 2018-04-06 Impact factor: 2.571