فهرست نشریات علمی دسترسی آزاد ایران

Background: Although Abdominoperineal Resection (APR) rates have declined over the last fifty years, it remains the best treatment option in many circumstances. Objectives: This study aimed to investigate the short-term outcomes of two-stage versus three-stage laparoscopic abdominoperineal resection in rectal cancer. Methods: This retrospective cohort study included 113 patients with rectal cancer eligible for laparoscopic APR at Razavi Hospital in Mashhad from 2020 to 2023. Inclusion criteria were age over 18 and a confirmed diagnosis via pathology, while exclusion criteria included recurrent rectal cancer, anal canal, and rectosigmoidal tumors, tumors located more than 15 centimeters from the anal verge, and concurrent colonic lesions. Data analysis was conducted using R software and SPSS. Results: The study included 42 patients undergoing a two-step surgical technique and 71 patients with a three-step technique. Results showed that the two-step group had a longer mean hospital stay (9.48 ± 4.09 days) than the three-step group (7.63 ± 1.30 days; p = 0.002). Surgical site infections occurred in 15.6% of the two-step patients, whereas none occurred in the three-step group (p=0.020). The mean surgery duration was also longer in the two-step group (222.18±56.08 minutes) than in the three-step group (170.78±29.13 minutes; p=0.00). Revision surgery was required in 23.8% of the two-stage group, compared with 4.2% in the three-stage group (p=0.002). Blood transfusion rates were similar: 23.8% in the two-step group and 22.5% in the three-step group (p=0.876). Conclusion: The three-stage approach to APR may improve surgical outcomes. However, larger prospective studies are needed to confirm these findings.