[A meta-analysis of clinical outcomes after laparoscopic operation for rectal cancer].
OBJECTIVE
To evaluate the clinical outcomes after laparoscopic surgery for rectal cancer.


METHODS
A systematic literature search (Medline, Embase, Cochrane Library) as of March 2010 was performed to identify all eligible studies. Two reviewers independently screened and extracted the data. Differences in short-term and long-term clinical outcomes after laparoscopic resection (LR) and open resection (OR) were analyzed using RevMan 5.


RESULTS
A total of 1042 abstracts were retrieved and 16 clinical controlled studies finally included. The total number of patients was 2850. There were 1145 patients received LR and 1705 received OR. The analyses showed that LR had longer operative time (WMD=42.50, 95%CI: 29.27 to 55.74, P<0.05), less harvested lymph nodes (WMD=-0.94, 95%CI: -1.47 to -0.41, P<0.05), and less blood loss (WMD=-158.46, 95%CI: -221.08 to -95.84, P<0.05) as compared to OR. LR was superior to OR in terms of surgical mortality (OR=0.40, 95%CI: 0.18 to 0.92, P=0.03), postoperative complications (OR=0.73, 95%CI: 0.61 to 0.87, P<0.05), and 5-year overall survival rate (OR=1.56, 95%CI: 1.21 to 2.02, P<0.05). There was no significant difference in positive rate of circumferential resection margin between the two groups (OR=1.00, 95%CI: 0.45 to 2.20, P=1.00).


CONCLUSIONS
Compared to open surgery, short-term and long-term clinical outcomes after laparoscopic surgery are favorable.
Department of Minimally Invasive Surgery, The Wuxi People's Hospital, Nanjing Medical University, Jiangsu Wuxi 214023, China.
Tao
T
Gong
Xiong
X
Zhou
Hui-qiang
HQ
Dou
Ke-ming
KM
Zhang
Tong
T
Wang
D018849:Controlled Clinical Trials as Topic; D006801:Humans; D010535:Laparoscopy; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome