Laparoscopic versus open rectectomy for rectal cancer: a meta-analysis of results of randomized cont

• 作 者: Xiong Binghong Ma Li Cheng Yong Zhang Caiquan
• 机 构: Department of General Surgery, the First Affiliated Hospital of Chongqing Medical University
• 出 处: 2013年肿瘤多学科综合诊治新进展学术研讨会
• 发表日期: 2013年12期
• 关键词: rectal cancer laparoscopy recurrence mortality meta-analysis

　　Objective Whether laparoscopic-assisted surgery can achieve the same oncologic outcomes compared with open surgery for rectal cancer remains controversial.The aim of this meta-analysis of randomized controlled trials (RCTs) is to compare the recurrence and mortality between laparoscopic rectectomy and conventional open rectectomy for rectal cancer with meta-analysis.Methods Eligible articles were identified by searches of MEDLINE, EMBASE and the Cochrane database between January 1991 and October 2012 using the terms (laparoscopy, surgery, minimal invasive, rectectomy, rectal neoplasms and randomized controlled trial).Prospective randomized clinical trials (RCTs) were eligible if they included patients with rectal cancer treated by laparoscopic surgery versus open surgery followed-up by recurrence and mortality.Data were extracted from these trials by two independent reviewers.Results There are 12 RCTs with recurrence and mortality information of 2259 patients were involved.In the combined results, no significant difference in the OR for overall recurrence between the laparoscopic surgery and open surgery group was found (OR 0.92, 95% CI: 0.66 to 1.28, P=0.61).Stratified by recurrence type, the combined results of the individual reports showed no significant differences for local recurrence (OR 0.79, 95% CI: 0.49 to 1.28, P=0.34), distant metastasis (OR 0.87, 95% CI: 0.59 to 1.27, P=0.47) and port-site or wound-site recurrence (OR 1.34, 95 % CI: 0.07 to 24.10, P=0.84) between the two surgical techniques.There was no significant difference in the overall mortality (OR 0.80, 95 % CI: 0.60 to 1.07, P=0.13) and cancer-related mortality (OR 0.71, 95 % CI: 0.45 to 1.12, P=0.14) between the two groups.Conclusions The recurrence and mortality rates for patients with rectal cancer treated by laparoscopic surgery do not differ significantly from those by open surgery.Longer follow up RCTs will further define outcomes comparing the two techniques in the treatment of rectal cancer.