A meta-analysis of short-term outcomes of laparoscopic and open total mesorectal excision for rectal cancer in China / 中国医师杂志

ABSTRACT

Objective To investigate the clinical short-term outcomes after laparoscopic total mesorectal excision (TME)for rectal cancer in China.Methods A systematic literature searching was performed to identify all randomized controlled trial(RCT) studies or well-designed retrospective studies on laparoscopic surgery(LS) and open surgery(OS) for rectal cancer published from January 2003 to October 2010 in China.Two reviewers independently screened and extracted the data.The reports which matched the inclusion criteria were analyzed with Revman 5.2.Results A total of 17 RCT studies and 3 retrospective studies (2246 patients)was included in this study.The basic features of 2 groups were balance.Compared to group OR,the incidence of complications such as postoperative wound infection (RR =0.30,95 ％ CI0.17 ～0.54,P ＜ 0.01),pulmonary infection (RR =0.47,95％ CI0.25 ～0.91,P ＜0.05),and ileus (RR =0.41,95％ CI0.19 ～0.88,P ＜0.05)were significantly lower in group LS.No difference was observed in the incidence of peritoneal abscess(RR =0.78,95％ CI0.38 ～ 1.60,P ＞0.05),anastomotic leakage(RR =0.66,95％ CI0.38 ～ 1.16,P ＞0.05),and uroschesis(RR =0.57,95％ CI0.26 ～ 1.25,P ＞0.05).Furthermore,parameters of postoperative recovery were compared between groups,LS group manifested early recovery.Conclusions Laparoscopic total mesorectal excision for rectal cancer,with minimal invasion,benefits the postoperative recovery and reduces incidence of complications.LS radical resection of rectal cancer is technically feasible,safe,and prospectively favorable.