Laparoscopic and open Dixon surgery about rectal cancer：A controlled clinical trail

Objective To make a review and evaluation for the security and effectiveness about the laparoscopic and conventional open Dixon surgery. Methods Between 2010 to 2015, 656 rectal cancer patients underwent Dixon surgery including 274 laparoscopic surgery and 382 conventional open operation in the first affiliated hospital of Anhui Medical University, all of them do not receive preventive stoma. The operation time, peroperative bleeding, postoperative recovery (including time to anal exhaust, time drinking water, time to get out of bed, time to be hospitalized, etc.), postoperative complications (including pleural effusion, perioperative mortality, anastomotic fistula, incision infection, postoperative bleeding, and secondary surgery), pathological indicators (including the number of lymph nodes, number of positive lymph nodes, cutting edge, TNM stage, tumor diameter, etc.) about the two group patients were collected and compared; the follow up time were from 6 months to 56 months to observe the prognosis of patients. Results Twenty patients (7.30%) in the laparoscopic group converted to the open surgery. Total 6 patients died in perioperative period, 2 of them were the laparoscopic group. Laparoscopic surgery was significantly associated with lower intraoperative blood loss, earlier recovery of bowel function, reduced length of hospital stay and time to feeding liquids, as compared to open surgery, although with increased operative time. It also showed an obvious advantage for postoperative complications of postoperative hemorrhage and the infection, the laparoscopic approach was equal to open approach as regard to bowel obstruction and pyoperitoneum. The pathological examination of 656 patients after resection showed 2 cases of positive distal margin, all of them were from open group. Importantly, there were no significant differences in the number of lymph node dissection, local recurrence rates, distant metastasis rates and 3-year survival rates between the two procedures. Conclusion Laparoscopic Dixon surgery for rectal cancer is feasible and safe, and can make faster recovery, achieve satisfactory oncological outcome and provide similar short-term and long-term outcomes.