Comparison of Short and Long Term Outcomes for Open vs. Laparoscopic Assisted Abdominoperineal Resection for Rectal Cancer

The abdominoperineal resection (APR) has been regarded as the gold standard for the surgical treatment of lower-lying rectal cancer (also for cases of sphincter or puborectal muscle invasion) [1]. APRs require the total mesorectal excision of the rectum and anal sphincters, resulting in the formation of a permanent colostomy. Laparoscopic surgery for colorectal cancer is being performed increasingly worldwide. In recent years, the results of a few large randomized trials were published; these results confirmed that perioperative outcomes were better after laparoscopic surgery of colon cancer compared to open surgery, but the morbidity and survival rates were not significantly different [2,3]. However, the role of minimally invasive (laparoscopic or robotic) surgery for rectal cancer is still debated, and oncologic safety is still controversialalthough a few large randomized multicentric trials reported that laparoscopic surgery for rectal cancer does not increase the morbidity rate and oncologic outcomes were not significantly different compared to open surgery [4-6].