ArticleSurgical endoscopy2020
Laparoscopic and open surgery in rectal cancer patients in Germany: short and long-term results of a large 10-year population-based cohort.
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 26 papers, 5 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The perioperative results of robotic and laparoscopic surgery for rectal cancer in obese patients: a systematic review and meta-analysis.World journal of surgical oncology · 2025Pooled it
- Laparoscopy is non-inferior to open surgery for rectal cancer: A systematic review and meta-analysis.Cancer medicine · 2024Pooled it
- Impact of laparoscopic versus open surgery on humoral immunity in patients with colorectal cancer: a systematic review and meta-analysis.Surgical endoscopy · 2024Pooled it
- Comparison of Survival Among Adults With Rectal Cancer Who Have Undergone Laparoscopic vs Open Surgery: A Meta-analysis.JAMA network open · 2022Pooled it
- Mid- and low-rectal cancer: laparoscopic vs open treatment-short- and long-term results. Meta-analysis of randomized controlled trials.International journal of colorectal disease · 2022Pooled it
- Indirect evidence for the volume-outcome relationship for corrective surgery for anorectal malformations using the IQWIG V24-07 rapid report methodology.Pediatric surgery international · 2026Article
- Efficacy and safety of combining intestinal stenting with laparoscopic surgery in colorectal cancer patients with acute intestinal obstruction.World journal of gastrointestinal surgery · 2025Article
- [Robotic rectal surgery].Chirurgie (Heidelberg, Germany) · 2024Review
- Article
- Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes.The world journal of men's health · 2024Review
- Short-term results in a population based study indicate advantage for minimally invasive rectal cancer surgery versus open.BMC surgery · 2024Article
- Laparoscopic rectal cancer resection yields comparable clinical and oncological results with shorter hospital stay compared to open access: a 5-year national cohort.International journal of colorectal disease · 2023Article
- Robotic Total Mesorectal Excision for Low Rectal Cancer: A Narrative Review and Description of the Technique.Journal of clinical medicine · 2023Article
- Influence of Laparoscopic Surgery on Cellular Immunity in Colorectal Cancer: A Systematic Review and Meta-Analysis.Cancers · 2023Review
- Watch and Wait Approach for Rectal Cancer.Journal of clinical medicine · 2023Review
- Laparoscopic extralevator abdominoperineal excision in distal rectal cancer patients: a retrospective comparative study.BMC surgery · 2022Article
- Minimally Invasive Pancreatoduodenectomy: Contemporary Practice, Evidence, and Knowledge Gaps.Oncology and therapy · 2022Article
- Implementation of a standardized surgical technique in robot-assisted restorative rectal cancer resection: a single center cohort study.BMC surgery · 2022Article
- Renal outcomes of laparoscopic versus open surgery in patients with rectal cancer: a propensity score analysis.Kidney research and clinical practice · 2021Article
- Propensity Score-Matched Analysis of Laparoscopic versus Open Surgery for Non-Metastatic Rectal Cancer.Asian Pacific journal of cancer prevention : APJCP · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRectal cancer is frequent in Germany and worldwide. Several studies have assessed laparoscopic surgery as a treatment option and most have shown favorable results. However, long-term oncologic safety remains a controversial issue.
methodsThe current dataset derives from 30 clinical cancer registries in Germany and includes 16,378 patients diagnosed with rectal cancer between 2007 and 2016. Outcomes were 90-day mortality, overall survival (OS), local recurrence-free survival (RFS) and relative survival of patients treated with either open or laparoscopic surgery. Multivariable logistic regression was used to evaluate factors that affected the probability of a patient undergoing laparoscopic surgery as well as to evaluate short-term mortality. OS and RFS were analyzed by Kaplan-Meier plots and multivariable Cox regression conducted separately for UICC stages I-III, tumor location, and sex as well as by propensity score matching followed by univariable and multivariable survival analysis.
resultsOf 16,378 patients, 4540 (27.7%) underwent laparoscopic surgery, a trend which increased during the observation period. Patients undergoing laparoscopy attained better results for 90-day mortality (odds ratio, OR 0.658, 95% confidence interval, CI 0.526-0.822). The 5-year OS rate in the laparoscopic group was 82.6%, vs. 76.6% in the open surgery group, with a hazard ratio (HR) of 0.819 in multivariable Cox regression (95% CI 0.747-0.899, p < 0.001). The laparoscopic group showed a better 5-year RFS, with 81.8 vs. 74.3% and HR 0.770 (95% CI 0.705-0.842, p < 0.001). The 5-year relative survival rates were also in favor of laparoscopy, with 93.1 vs. 88.4% (p = 0.012).
conclusionLaparoscopic surgery for rectal cancer can be performed safely and, according to this study, is associated with an oncological outcome superior to that of the open procedure. Therefore, in the absence of individual contraindications, it should be considered as a standard approach.
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