Objective: To investigate the impact of previous abdominal surgery on short-term outcomes in laparoscopy-assisted radical resection for rectal cancer.
Methods: Clinical data of 731 consecutive patients with rectal cancer who underwent laparoscopy-assisted radical resection in Union Hospital from January 2000 to December 2012 were retrospectively analyzed. Patients were classified as having previous abdominal surgery(PAS group, n=121) or not having previous abdominal surgery (NPAS group, n=610). Short-term outcomes including intraoperative and postoperative parameters were compared. Data were analyzed by independent sample t-test, Chi-square test or Fisher's exact probability.
Results: The mean number of lymph nodes dissected was 18.8 ± 7.9 in PAS group and 18.9 ± 8.2 in NPAS group, the length of proximal resection margin was (15.0 ± 1.2) cm and (15.1 ± 1.3) cm respectively, the length of distal resection margin was (3.9 ± 1.4) cm and (3.8 ± 1.5) cm respectively. The differences between the two groups were not statistically significant(all P>0.05). Moreover, there were no significant differences in operative time, intraoperative blood loss, intraoperative blood transfusion, sphincter preservation operation rate, conversion rate, time to first flatus, time to liquid intake, postoperative ambulation time, postoperative hospital stay, -and postoperative complication rate between the two groups(all P>0.05). However, postoperative ileus was more frequent in PAS group than that in NPAS group(5.0% vs. 1.5%, P<0.05).
Conclusions: Laparoscopy- assisted radical resection is safe and feasible for patients with rectal cancer who experienced abdominal operations. But the prevention and treatment of postoperative ileus should be handled with caution.