Short- and long-term outcomes of laparoscopic versus open surgery for rectal cancer: A systematic review and meta-analysis of randomized controlled trials

Medicine (Baltimore). 2018 Dec;97(50):e13704. doi: 10.1097/MD.0000000000013704.

Abstract

Objectives: The present meta-analysis aimed to evaluate the short- and long-term outcomes of laparoscopic surgery (LS) versus open surgery (OS) for rectal cancer.

Methods: PubMed, Web of Science, and Cochrane Library, were searched for eligible randomized controlled trials (RCTs) published up to June 2017. Operation related index, postoperative complication, and long-term survival rate and disease-free survival rate were evaluated by meta-analytical techniques.

Result: Nine RCTs enrolling 4126 patients were included in the present meta-analysis. Compared to OS, LS had similar positive circumferential resection margin (CRM) and number of lymph nodes extracted (LNE) as well as long term 5 years survival rate and disease-free survival rate, but of which the risk tendency was higher in LS group. The short-term outcomes of major and total postoperative complication were lower in LS group.

Conclusions: LS for rectal cancer was as safe and effective as OS in terms of long-term outcomes, but with lower postoperative complication.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Laparoscopy* / statistics & numerical data
  • Lymph Node Excision* / adverse effects
  • Lymph Node Excision* / methods
  • Lymph Node Excision* / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Randomized Controlled Trials as Topic
  • Rectal Neoplasms* / mortality
  • Rectal Neoplasms* / surgery
  • Treatment Outcome