• Marylise Boutros, Neha Hippalgaonkar, Emanuela Silva, Daniela Allende, Steven D Wexner, and Mariana Berho.
• Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
• Dis. Colon Rectum. 2013 Jun 1;56(6):679-88.

BackgroundPrognosis in rectal cancer is closely related to mesorectal integrity, margin status, and adequate lymph node dissection. The impact of laparoscopy on the pathologic and short-term outcomes remains controversial.ObjectiveWe aim to compare the pathologic and short-term outcomes of laparoscopic and open resections for rectal cancer.DesignThis is a large single-center retrospective comparative study using a prospective database.PatientsAll patients who underwent primary resections for rectal cancer from January 2007 to September 2011 were identified.Main Outcome MeasuresPathologic (nodal harvest, mesorectal integrity, circumferential, and distal margins) and operative outcomes were measured.ResultsTwo hundred thirty-four (mean age, 61 years; 65% male) patients underwent resections for primary rectal cancer, including 118 laparoscopic (99 restorative proctectomies, 19 abdominoperineal resections) and 116 open (69 restorative proctectomies, 47 abdominoperineal resections) resections. Both groups were similar in demographics, comorbidities, and tumor characteristics. The laparoscopic group had significantly more lymph nodes (26 vs 21, p = 0.02) than the open group, with no differences in circumferential margins, proportion of distal resection margins ConclusionsLaparoscopy for primary rectal cancer is associated with a greater number of lymph nodes as well as short-term benefits.

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