Comparison of outcomes of minimally invasive surgery and open surgery for rectal cancer.

Abstract

e15601 Background: Minimally Invasive Surgery (MIS) is recently gaining traction due to improved intra and peri operative outcomes. In comparison to the conventional open approach, MIS has been shown to have reduced blood loss and faster recovery time. Conversely, it is associated with higher cost due to expensive instruments and equipment. It is also linked to complications such as neoplastic recurrence in incision sites, intra abdominal vessel injury and bowel perforation. MIS like Laparoscopic Abdominoperineal Resection is a feasible and comparable alternative to conventional Abdominoperineal Resection. This study aims to compare minimally invasive and open approaches with respect to perioperative and pathological outcomes. Methods: Patients who underwent total mesorectal excision in our institution from January 2020 to January 2021 were retrospectively reviewed. The patients were divided into 2 groups based on the method of approach - minimally invasive and open. Robotic and laparoscopic approaches were combined into the minimally invasive approach. Perioperative and pathological outcomes were compared between the two groups. Results: A total of 83 patients underwent rectal resections during this time period, of which 52 were done through a minimally invasive approach. The mean age of this cohort was 52 years and 64% were men. Blood loss was significantly decreased in the MIS group. Other operative parameters like hospital stay, rates of wound infection and duration of surgery were not significantly different between the groups.Total lymph nodes dissected, TME completion rate and CRM involvement also showed no significant difference between the groups. 25 out of 83 patients showed lymph node spread on histopathological examination, but this did not show any significant differences between approaches. The distribution of Clavien Dindo grades of complications was roughly equal between the two groups. Conclusions: Minimally Invasive Surgery for mesorectal excision shows significantly lower blood loss in comparison to the Open approach. Peri operative parameters like hospital stay, rates of wound infection were comparable. Hence, Minimally Invasive Surgery shows more positive outcomes compared to Open Approach.