title: Laparoscopic Versus Open Colorectal Resection Within Fast Track Programs: An Update Meta-Analysis Based on Randomized Controlled Trials.
abstract: The objective of the study was to assess the safety and efficacy of laparoscopic colorectal surgery by comparing open operation within fast track (FT) programs. The Cochrane Library, PubMed, Embase and Chinese Biological Medicine Database were searched to identify all available randomized controlled trials (RCTs) comparing laparoscopic with open colorectal resection within FT programs. A total of seven RCTs were finally included, enrolling 714 patients with colorectal cancer: 373 patients underwent laparoscopic surgery and FT programs (laparoscopic/FT group) and 341 patients received open operation and FT programs (open/FT group). Postoperative hospital stay (weighted mean difference (WMD): 0.66; 95% CI: 0.27 - 1.04; P < 0.05), total hospital stay (WMD: 1.46; 95% CI: 0.40 - 2.51; P < 0.05) and overall complications (RR: 1.31; 95% CI: 1.12 - 1.54; P < 0.05) were significantly lower in laparoscopic/FT group than in open/FT group. However, no statistically significant differences on mortality (risk ratio (RR): 2.26; 95% CI: 0.62 - 8.22; P = 0.21), overall surgical complications (RR: 1.19; 95% CI: 0.94 - 1.51; P = 0.15) and readmission rates (RR: 1.33; 95% CI: 0.79 - 2.22; P = 0.28) were found between both groups. The laparoscopic colorectal surgery combined with FT programs shows high-level evidence on shortening postoperative and total hospital stay, reducing overall complications without compromising patients' safety.
authors.affiliation: Department of General Surgery, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Qiu-Cheng
authors.initials: QC
authors.lastname: Lei
authors.affiliation: Department of General Surgery, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu Province, China ; Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China.
authors.forename: Xin-Ying
authors.initials: XY
authors.lastname: Wang
authors.affiliation: Key Laboratory for Medical Molecular Diagnostics of Guangdong Province, Guangdong Medical College, Dongguan, Guangdong Province, China.
authors.forename: Hua-Zhen
authors.initials: HZ
authors.lastname: Zheng
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Faculty of Medicine, the Chinese University of Hong Kong, China.
authors.forename: Xian-Feng
authors.initials: XF
authors.lastname: Xia
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China.
authors.forename: Jing-Cheng
authors.initials: JC
authors.lastname: Bi
authors.affiliation: Department of General Surgery, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu Province, China.
authors.forename: Xue-Jin
authors.initials: XJ
authors.lastname: Gao
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
keywords: Colorectal surgery; Enhanced recovery after surgery; Fast track programs; Laparoscopic surgery; Meta-analysis