Abstract
BACKGROUND: To investigate the short- and medium-term outcomes of using a reduced-port laparoscopic surgery (RPLS), compared to multi-port laparoscopic surgery (MPLS), for the treatment of upper rectal cancer (URC) among elderly patients. METHODS: We conducted a retrospective analysis of the clinical and follow-up data of 181 elderly patients with URC, who underwent radical laparoscopic surgery at our hospital, between January 2015 and January 2019. Among these 181 cases, 62 underwent RPLS and 119 MPLS. RESULTS: Compared to MPLS, RPLS decreased the length of surgical incision, lower pain on postoperative days 1 and 2, decreased the time to first flatus after surgery, as well as the time to mobilization after surgery. There was no difference between the short-term outcomes between the two laparoscopic approaches, and no difference in the 3-year disease-free and overall survival rate. CONCLUSION: Compared to MPLS, RPLS provides several advantages for the treatment of URC among elderly individuals, including a shorter length of surgical incision, reduced postoperative pain, shorter time to first flatus after surgery, earlier mobilization, and better cosmetic outcomes. These advantages are achieved with no difference in the length of surgery, nor in the 3-year disease-free and overall survival rate, compared to MPLS.