Pathologic Outcomes of Laparoscopic vs Open Mesorectal Excision For Rectal Cancer

To the Editor In their recent article inJAMA Surgery, Mart ínez-Pérez et al question the oncological safety of laparoscopic surgery in patients with rectal cancer. Their conclusion differs from the findings of a systematic review by Arrezzo et al, who concluded that laparoscopic resection of rectal cancer was oncologically safe. Inclusion of the early res ults of the ACOSOG and ALaCaRT trials in the meta-analysis by Martínez-Pérez et al led to their recommendation to await long-term outcome studies before determining the definitive role of laparoscopic surgery in patients with rectal cancer. Although more than 400 patients were accrued in both tria ls, the 95% CIs of the ACOSOG and ALaCaRT trials ranged from −11.0 and −12.4, respectively, to infinity, qualifying these trials as lev...

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