title: A meta-analysis of laparoscopy compared with open colorectal resection for colorectal cancer.
abstract: The aim of this study was to compare the outcome of the overall complication, mortality, and recurrence rate between laparoscopic resection and open surgery for colorectal cancer. We searched the Medline, Embase, and Cochrane Library and systematically reviewed the randomized controlled trials by comparing the overall complication, mortality, and recurrence rate between laparoscopic resection and open surgery for colorectal cancer. Fifteen trials with 4,207 patients who reported long-term outcomes of the overall complication, mortality, and recurrence rate were included. The combined results of the individual trials showed no statistically significant difference in the odds ratio (OR) for overall recurrence (OR 0.92, 95% CI, 0.77-1.11, P=0.34), local recurrence (OR 0.81, 95% CI, 0.59-1.12, P=0.20), distant metastasis (OR 1.01, 95% CI, 0.78-1.30, P=0.95), wound-site recurrence (OR 1.97, 95% CI, 0.77-5.02, P=0.16), colorectal cancer-related mortality (OR 0.82, 95% CI, 0.66-1.02, P=0.07), colon cancer-related mortality (OR 0.85, 95% CI, 0.66-1.09, P=0.20), rectal cancer-related mortality (OR 0.76, 95% CI, 0.53-1.11, P=0.16), and overall mortality (OR 0.87, 95% CI, 0.73-1.73, P=0.11) between the laparoscopic surgery and open surgery groups. The overall complications in the laparoscopic surgery group were much lower than that in the open surgery group (OR 0.71, 95% CI, 0.58-0.87, P=0.001). This meta-analysis showed that the successful laparoscopic colorectal resection for colorectal cancer was as effective as open surgery in terms of the oncological outcomes, thereby suggesting that laparoscopic surgery can be continued in patients with colorectal cancer.
authors.affiliation: Department of Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, People's Republic of China.
authors.forename: Yanlei
authors.initials: Y
authors.lastname: Ma
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yang
authors.forename: Huanlong
authors.initials: H
authors.lastname: Qin
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
mesh_terms: D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic
references.citation: Dis Colon Rectum. 1996 Oct;39(10 Suppl):S20-3
references.pmid: 8831542
references.citation: N Engl J Med. 2004 May 13;350(20):2050-9
references.pmid: 15141043
references.citation: Br J Surg. 1997 Mar;84(3):358-61
references.pmid: 9117307
references.citation: World J Surg. 1999 Aug;23(8):801-7
references.pmid: 10415206
references.citation: Br J Surg. 1998 Oct;85(10):1439-42
references.pmid: 9782033
references.citation: J Am Coll Surg. 1998 Jul;187(1):46-54; discussion 54-5
references.pmid: 9660024
references.citation: Br J Surg. 1997 Mar;84(3):391-6
references.pmid: 9117320
references.citation: Ann Surg Oncol. 2007 Jan;14(1):109-17
references.pmid: 17066227
references.citation: Surg Endosc. 2004 Jun;18(6):898-906
references.pmid: 15108105
references.citation: Lancet. 1994 Jul 2;344(8914):58
references.pmid: 7912321
references.citation: Surg Endosc. 2000 Nov;14(11):1062-6
references.pmid: 11116420
references.citation: Eur J Surg Oncol. 2008 Nov;34(11):1217-24
references.pmid: 18155389
references.citation: Surg Endosc. 2004 Aug;18(8):1211-5
references.pmid: 15457380
references.citation: Rev Hosp Clin Fac Med Sao Paulo. 2003 May-Jun;58(3):133-40
references.pmid: 12894309
references.citation: Cancer Treat Rev. 2008 Oct;34(6):498-504
references.pmid: 18468803
references.citation: Lancet. 2004 Apr 10;363(9416):1187-92
references.pmid: 15081650
references.citation: Lancet. 2002 Jun 29;359(9325):2224-9
references.pmid: 12103285
references.citation: J Laparoendosc Adv Surg Tech A. 2008 Oct;18(5):679-85
references.pmid: 18699750
references.citation: Br J Surg. 2001 Jun;88(6):801-7
references.pmid: 11412248
references.citation: Surg Endosc. 2004 Aug;18(8):1163-85
references.pmid: 15457376
references.citation: Ann Surg. 1996 Jun;223(6):790-6; discussion 796-8
references.pmid: 8645052
references.citation: Ann Surg. 1992 Dec;216(6):703-7
references.pmid: 1466626
references.citation: Aust N Z J Surg. 1999 Jul;69(7):479-85
references.pmid: 10442917
references.citation: J Laparoendosc Adv Surg Tech A. 2004 Dec;14(6):329-34
references.pmid: 15684776
references.citation: Hepatogastroenterology. 2001 Sep-Oct;48(41):1248-51
references.pmid: 11677939
references.citation: J Clin Oncol. 2007 Jul 20;25(21):3061-8
references.pmid: 17634484
references.citation: Br J Surg. 2004 Sep;91(9):1111-24
references.pmid: 15449261
references.citation: Br J Surg. 1995 Mar;82(3):295-8
references.pmid: 7795990
references.citation: Dis Colon Rectum. 2005 Dec;48(12):2217-23
references.pmid: 16228828
references.citation: Dis Colon Rectum. 1996 Oct;39(10 Suppl):S35-46
references.pmid: 8831545
references.citation: Surg Endosc. 2009 Aug;23(8):1818-24
references.pmid: 19118433
references.citation: Ann Med. 1997 Dec;29(6):477-81
references.pmid: 9562513
references.citation: Am J Surg. 1984 Sep;148(3):303-7
references.pmid: 6236703
references.citation: Surg Endosc. 2002 Oct;16(10):1420-5
references.pmid: 12085142
references.citation: Lancet Oncol. 2005 Jul;6(7):477-84
references.pmid: 15992696
references.citation: Surgery. 1996 Mar;119(3):316-25
references.pmid: 8619187
references.citation: J Surg Oncol. 1985 Nov;30(3):139-44
references.pmid: 3908826
references.citation: Lancet. 1993 Jan 23;341(8839):249-50
references.pmid: 8093539
references.citation: Lancet. 2005 May 14-20;365(9472):1718-26
references.pmid: 15894098
references.citation: J Am Coll Surg. 2003 Aug;197(2):177-81
references.pmid: 12892794
references.citation: N Engl J Med. 1991 Apr 18;324(16):1073-8
references.pmid: 1826143
references.citation: Arch Surg. 2000 Aug;135(8):948-58
references.pmid: 10922258
references.citation: N Engl J Med. 1994 Feb 10;330(6):409-19
references.pmid: 8284008