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Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer . BACKGROUND The laparoscopic treatment of rectal cancer is controversial . This study compared surgical outcomes after laparoscopic and open approaches for mid and low rectal cancers . METHODS Some 204 patients with mid and low rectal adenocarcinomas were allocated randomly to open ( 103 ) or laparoscopic ( 101 ) surgery . The surgical team was the same for both procedures . Most patients had stage II or III disease , and received neoadjuvant therapy with oral capecitabine and 50-54 Gy external beam radiotherapy . RESULTS Sphincter-preserving surgery was performed in 78.6 and 76.2 per cent of patients in the open and laparoscopic groups respectively . Blood loss was significantly greater for open surgery ( P < 0.001 ) and operating time was significantly greater for laparoscopic surgery ( P = 0.020 ) , and return to diet and hospital stay were longer for open surgery . Complication rates , and involvement of circumferential and radial margins were similar for both procedures , but the number of isolated lymph nodes was greater in the laparoscopic group ( mean 13.63 versus 11.57 ; P = 0.026 ) . There were no differences in local recurrence , disease-free or overall survival . CONCLUSION Laparoscopic surgery for rectal cancer has a similar complication rate to open surgery , with less blood loss , rapid intestinal recovery , shorter hospital stay , and no compromise of oncological outcomes .
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Intervention_Surgical
laparoscopic
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Intervention_Surgical
open surgery
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Intervention_Surgical
laparoscopic treatment
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Intervention_Surgical
laparoscopic
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Intervention_Surgical
open
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Intervention_Surgical
laparoscopic ( 101 ) surgery
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Intervention_Pharmacological
neoadjuvant therapy
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Intervention_Pharmacological
oral capecitabine and
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Intervention_Physical
50-54 Gy external beam radiotherapy
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Intervention_Surgical
Sphincter-preserving surgery
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Intervention_Surgical
open
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Intervention_Surgical
open surgery
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Intervention_Surgical
laparoscopic surgery
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Intervention_Surgical
open surgery
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Intervention_Surgical
laparoscopic
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Intervention_Surgical
Laparoscopic surgery
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Intervention_Surgical
open surgery
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Outcome_Adverse-effects
Blood loss
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Outcome_Other
operating time
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Outcome_Other
hospital stay
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Outcome_Adverse-effects
Complication rates , and involvement of circumferential and radial margins
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Outcome_Mortality
local recurrence , disease-free or overall survival .
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Outcome_Adverse-effects
blood loss
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Outcome_Adverse-effects
intestinal recovery
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Outcome_Other
hospital stay
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Outcome_Physical
oncological outcomes .
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Participant_Condition
rectal cancer
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Participant_Sample-size
204
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Participant_Condition
mid and low rectal adenocarcinomas