Int J Colorectal Dis (2012) 27:1077–1085 Fig. 3 a Comparison of overall survival of patients with rectal cancer (all stages). b Comparison of overall survival of patients with stage I rectal cancer. c Comparison of overall survival of patients with stage II rectal cancer. d Comparison of overall survival of patients with stage III rectal cancer 1081 Laparoscopic Open Laparoscopic Open p=0.005 p=0.883 Laparoscopic Open Laparoscopic Open p=0.005 p=0.176 comparison of overall survivals of patients with stage I, II, and III diseases is shown in Fig. 2a–c, respectively. In patients with stage II or stage III cancer, significantly better overall survival was found in those who underwent laparoscopic resection. The comparison of overall survivals of patients with rectal and colon cancer are shown in Figs. 3a and 4a, respectively. While there was no difference in survival in patients with colon cancer, laparoscopic resection was associated with better sur- vivals in patients with rectal cancer. The overall survivals of patients with different stages of diseases of rectal cancer and colon cancer are shown in Figs. 3b–d and 4b–d, respectively. There was no difference in survival in patients with stage I disease. The improvement in survival in the laparoscopic group occurred mainly in patients with stage II disease (both colon and rectal cancer). There was also a trend towards better survival in patients with stage III disease, although it did not show any statistical significance. Other factors that influence overall and disease specific survivals in univariate analysis are shown in Table 3. Besides, the surgical approach, the survival is most related to the histological findings of the tumor. The results of multivariate analysis of overall and disease specific survivals are shown in Tables 4 and 5, respectively. On multivariate analysis, laparo- scopic resection remained one of the independent factors associated with better overall survival as well as disease specific survival. Discussion Colorectal cancer is a common malignancy, which usually occurs in the elderly age group. Many of the patients have significant medical co-morbidities, which affect the operative outcomes. Laparoscopic resection revolutionized the treat- ment of colorectal malignancy in recent years. With the intro- duction of laparoscopic resection, favorable operative outcomes in terms of less pain, less analgesic requirement, quick recovery of the gastrointestinal tract, and a shorter