Long-term morbidity and oncologic outcomes of laparoscopic-assisted anterior resection for upper rectal cancer: ten-year results of a prospective, randomized trial

Dis Colon Rectum. 2009 Apr;52(4):558-66. doi: 10.1007/DCR.0b013e31819ec20c.


Purpose: We have previously reported the five-year results of a randomized trial comparing laparoscopic and open resection for cancer of the upper rectum and rectosigmoid junction. The aim of this follow-up study is to report on the long-term morbidity and ten-year oncologic outcomes among the subgroup of patients with upper rectal cancer.

Methods: From September 1993 to October 2002, 153 patients with upper rectal cancer were randomly assigned to receive either laparoscopic-assisted (n = 76) or open (n = 77) anterior resection. Patients were last followed up in December 2007. Long-term morbidity, survival, and disease-free interval were prospectively recorded. Data were analyzed by intention-to-treat principle.

Results: The demographic data of the two groups were comparable. More patients in the open group developed adhesion-related bowel obstruction requiring hospitalization (P = 0.001) and intervention. The overall long-term morbidity rate was also significantly higher in the open group (P = 0.012). After curative resection, the probabilities of cancer-specific survival at ten years of the laparoscopic-assisted and open groups were 83.5 percent and 78.0 percent, respectively (P = 0.595), and their probabilities of being disease-free at ten years were 82.9 percent and 80.4 percent, respectively (P = 0.698).

Conclusion: Laparoscopic-assisted anterior resection for upper rectal cancer is associated with fewer long-term complications and similar ten-year oncologic outcomes when compared with open surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cause of Death
  • Digestive System Surgical Procedures
  • Disease-Free Survival
  • Female
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Morbidity
  • Prospective Studies
  • Rectal Neoplasms / mortality*
  • Rectal Neoplasms / surgery*
  • Survival Analysis
  • Treatment Outcome