Clinical safety and outcomes of laparoscopic surgery versus open surgery for palliative resection of primary tumors in patients with stage IV colorectal cancer: a meta-analysis.
This study was performed to compare the clinical safety and outcomes of laparoscopic versus open surgery for primary tumors in patients with stage IV colorectal cancer.



Pertinent studies were selected from the MEDLINE, EMBASE, and Cochrane Library databases; references from published articles; and reviews. Both prospective and retrospective studies were included for the meta-analysis. Clinical outcomes included safety, complications, mortality, and survival.



Six trials involving 1802 patients were included. The operative time was longer for laparoscopic than for open surgery (mean difference (MD) = 44.20, 95 % confidence interval (CI) 17.31-71.09, Z = 3.22, P = 0.001). Laparoscopic surgery was also associated with fewer postoperative complications (odds ratio 0.53, 95 % CI 0.37-0.78, Z = 3.29, P = 0.001) and less operative blood loss (MD = -65.40, 95 % CI -102.37 to -28.42, Z = 3.47, P = 0.0005). Median survival ranged from 11.4 to 30.1 months. The total hospital stay was 1.68 days shorter for laparoscopic than for open surgery (95 % CI -1.83 to -1.53, Z = 21.64, P < 0.00001).



Laparoscopic surgery for palliative resection of stage IV colorectal cancer is associated with better perioperative outcomes than open surgery.
Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, 200040, Shanghai, China.
Min-Wei
MW
Zhou
Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, 200040, Shanghai, China.
Xiao-Dong
XD
Gu
Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, 200040, Shanghai, China.
Jian-Bin
JB
Xiang
Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, 200040, Shanghai, China. zongyouc@sohu.com.
Zong-You
ZY
Chen
D016063:Blood Loss, Surgical; D003082:Colectomy / Q000379:methods* / Q000401:mortality; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D061646:Operative Time; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
Colorectal cancer; Laparoscopic surgery; Open surgery