LASRE focus.

In the Chinese phase 3 LASRE trial, 1039 patients with low rectal tumors (<5 cm from dentate line) were randomized 2:1 to laparoscopic or open total mesorectal excision. There was no difference in achieving negative resection margins (>98%) or in the median number of examined lymph nodes (12-13). Complication rates were decreased from 17% to 13% after laparoscopic surgery, and there was a significant decrease in post-op hospital stay from 9 to 8 days. Most newsworthy was the significant increase in sphincter preservation with laparoscopic (72%) versus open (65%) surgery. The thought is that a laparoscopic approach can afford confidence in aggressively sparing the sphincter as it allows for magnification and better visualization of deep pelvic structures. | Jiang, JAMA Oncol 2022