Short-term and Long-Term Outcomes of Laparoscopic Surgery for Locally Recurrent Rectal Cancer: A Propensity Score-Matched Cohort Study

Background Radical surgery remains the primary option for locally recurrent rectal cancer (LRRC) as it has the potential to considerably extend the patient's lifespan. At present, the effectiveness of laparoscopic surgery for LRRC remains unclear. Methods The clinical data of LRRC patients who were admitted to the Cancer Hospital of the Chinese Academy of Medical Sciences between 2015 and 2021 were retrospectively analyzed in this study. Patients were categorized into two groups, namely the open group and the laparoscopic group, based on the surgical method used. The short-term outcomes and long-term survival between the two groups were compared. Results Curative surgery was performed on 111 patients who were diagnosed with LRRC. After propensity score matching, a total of 84 patients were included and divided into the laparoscopic group (42 patients) and the open group (42 patients). The laparoscopic group had less intraoperative bleeding (100 vs. 300, P = 0.023), a lower postoperative complication rate (19.0% vs. 42.9%, P = 0.018), and a lower incidence of wound infection (0 vs. 14.3%, P = 0.026). Additionally, the laparoscopic group had a higher R0 resection rate than the open group (92.9% vs. 83.3%, P = 0.313), as well as a shorter length of hospital stay (9.5 vs. 11.5 days, P = 0.304), although these differences were not statistically significant. The laparoscopic group had higher 3-year overall survival (86.3% vs. 58.9%, P = 0.022) and 3-year disease-free survival (60.6% vs 32.7%, P = 0.015). Conclusions In comparison to open surgery, laparoscopic surgery is linked to less bleeding during the operation, quicker recovery after the surgery, and a lower incidence of infections at the surgical site. Moreover, laparoscopic surgery for LRRC might yield superior long-term survival outcomes.