Systematic review on safety and efficacy of lateral node dissection in rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of lateral node dissection in rectal cancer.</p><p><b>METHODS</b>Data of safety and efficacy in 27 case-controlled studies comparing lateral node dissection and non-lateral node dissection in rectal cancer were meta-analyzed using fixed effect model or random effect model.</p><p><b>RESULTS</b>The increased operating time, blood loss and urinary dysfunction were more common in lateral node dissection group. The postoperative total complications, pelvic abscess, anastomotic leak, sexual dysfunction and defecation dysfunction were similar in both groups. There was no reasonably clear evidence in favor of lateral node dissection for recurrence, local recurrence, distal metastasis and 5-year survival.</p><p><b>CONCLUSION</b>Lateral node dissection can neither reduce recurrence nor improve survival in the current study, which is not recommended to be a routine procedure in rectal cancer surgery.</p>

Safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis.</p><p><b>METHODS</b>A search of published studies in English and Chinese between January 1992 and May 2008 was performed. Nine hundred and twenty-three patients from 16 studies were recruited which met the inclusion criteria. Meta-analysis was performed through fixed effect model or random effect model dependent on heterogeneity.</p><p><b>RESULTS</b>Compared to open procedure, patients with ulcerative colitis undergone laparoscopic surgery were able to tolerate oral intake significantly earlier (P<0.01) with shorter hospital stay (P<0.01) and had lower total complication rate (P<0.01). But duration of laparoscopic surgery was significantly longer than that of open procedure(P=0.04). Laparoscopic procedure was no more superior to open procedure in recovery of bowel function, re-operation rate, intra-abdominal abscess, anastomotic leak, postoperative bowel obstruction, wound infection, blood loss and mortality. The conversion rate was 4.2% in this analysis.</p><p><b>CONCLUSION</b>Laparoscopic surgery for ulcerative colitis is safe and feasible with better recovery in short-term as compared to the open procedure.</p>