title: Dissemination metastasis after laparoscopic colorectal surgery versus conventional open surgery for colorectal cancer: a metanalysis.
abstract: OBJECTIVE
  The purpose of this systematic review is to evaluate and compare the risk of dissemination metastasis (wound, port-side metastases and peritoneal seeding) after laparoscopic colorectal surgery and conventional open surgery for colorectal cancer.
  
  
  METHODS
  The Authors searched relevant randomized controlled trials between January 1998 and July 2012.
  
  
  RESULTS
  Wound, port-site metastases and peritoneal seeding were rare and no significant differences occurred between the two groups. The port-site and extraction site recurrence were likely to be the results of suboptimal surgical techniques and occurred in the early phase of the learning curve. The authors also found no significant differences in overall, local and distant recurrences. No significant differences between laparoscopic and open surgery were found in cancer-related mortality during the follow up period of the study (7 RCTs, 3525 patients, 12.8% vs. 14.00%; OR (fixed) 0.83, 95% CI 0.68-1.02), with no significant heterogeneity (p = 0.35).
  
  
  CONCLUSIONS
  The literature supports the implementation of laparoscopic surgery into daily practice. Laparoscopic surgery can be used for safe and radical resection of cancer in the right, left, sigmoid colon and rectum. However further studies should address whether laparoscopic surgery is superior to open surgery in this setting.
authors.affiliation: Department of Surgery, University of Catania, Catania, Italy. amzanghi@unict.it  
authors.forename: A
authors.initials: A
authors.lastname: Zanghì
authors.forename: A
authors.initials: A
authors.lastname: Cavallaro
authors.forename: G
authors.initials: G
authors.lastname: Piccolo
authors.forename: R
authors.initials: R
authors.lastname: Fisichella
authors.forename: M
authors.initials: M
authors.lastname: Di Vita
authors.forename: D
authors.initials: D
authors.lastname: Spartà
authors.forename: G
authors.initials: G
authors.lastname: Zanghì
authors.forename: S
authors.initials: S
authors.lastname: Berretta
authors.forename: F
authors.initials: F
authors.lastname: Palermo
authors.forename: A
authors.initials: A
authors.lastname: Cappellani
mesh_terms: D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects*; D057225:Data Mining; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D009362:Neoplasm Metastasis; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016896:Treatment Outcome