Abstract
BACKGROUND: Rectal cancer is a serious worldwide health issue, and laparoscopic surgery is becoming a common therapeutic choice because of its advantages, which include less pain after surgery, quicker recovery, and oncological results that are comparable to those of open surgery. Even though laparoscopic rectal cancer surgery has proven successful in developed countries, it is still not well-studied in places with low resources, like Pakistan. OBJECTIVE: The primary objective of this study was to evaluate the clinical outcomes and surgical efficacy of laparoscopic rectal cancer surgery in 209 patients, focusing on operative details, histopathological findings, and postoperative complications. The secondary objective was to assess 90-day disease-free survival (DFS), mortality rates, and the need for reexploration or readmission. MATERIALS AND METHODS: This retrospective observational study was performed at the Surgical Oncology department, Shaukat Khanum Memorial Cancer Hospital, Peshawar, a high-volume center for colorectal surgery. Assessment of short-term surgical results of laparoscopic rectal cancer operation ensued from April 1, 2021, to March 31, 2024. The sample comprised 209 patients with rectal cancer who were treated by laparoscopic rectal cancer surgery. A consecutive sampling technique was used to enroll eligible patients during the study duration. RESULTS: The mean age of the patients was 43.07 ± 22.1 years. The male-to-female ratio was 1.4:1, with males comprising 131 patients (62.7%) and females, 78 patients (37.3%). The regional distribution included 54 (25.8%) from Afghanistan, 11 (5.2%) from the federally administered tribal area (FATA), 141 (67.5%) from Khyber Pakhtunkhwa (KPK), and three (1.4%) from Punjab. Preoperative assessment classified 191 (91.4%) patients as American Society of Anesthesiologists (ASA)-II, and 18 (8.6%) cases as ASA-III. CONCLUSION: Laparoscopic rectal cancer surgery demonstrates favorable short-term outcomes, including minimal morbidity, low conversion rates, and promising oncological results in a high-volume center in Peshawar, Pakistan. These findings support the feasibility of laparoscopic surgery for rectal cancer in resource-constrained settings.