Oncological Safety of Minimally Invasive Multivisceral Resection for cT4b Rectal Cancer: A Multicenter Comparison With Open Surgery

BACKGROUND/AIM: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is increasingly used for rectal cancer but evidence of multivisceral resection (MVR) for cT4b disease by MIS is limited. This study compared short- and long-term outcomes between patients who underwent MIS or open MVR for advanced rectal cancer. PATIENTS AND METHODS: We retrospectively analyzed 32 patients with cT4b rectal cancer who underwent rectal resection with MVR at six institutions between 2011 and 2023 (open, n=9; MIS, n=23). Operative invasiveness, postoperative complications, and 3-year survival were evaluated. After excluding those with stage IV disease (open, n=9; MIS, n=20), pathological outcomes and 3-year survival did not differ between groups. CONCLUSION: MIS may reduce invasiveness without compromising oncological outcomes in selected patients with cT4b rectal cancer requiring MVR.