A meta-analysis of short-term outcome of laparoscopic surgery versus conventional open surgery on colorectal carcinoma

Abstract

Objective:The aim of this article is to study the superiority and safety of laparoscopic surgery for colorectal carcinoma.Summary Background Data:Laparoscopy in rectal cancer is still not recommended as the treatment of choice by National Comprehensive Cancer Network guidelines. Laparoscopic rectal surgery is more complex and technically demanding, especially for mid and low rectal cancer.Methods:A computer-based online research of retrospective or prospective studies addressing laparoscopic surgery versus conventional open surgery for colorectal carcinoma published in the last 11 years was performed in electronic database (Wangfang Database, China National Knowledge Infrastructure, Chinese Medical Current Contents, Pubmed, Medline, Ovid, Elsevier, ISI Web of Knowledge, Cohrane Database of Systematic Reviews). Selective trials were analyzed by the Review Manager 5.2 software.Results:A total of 9 clinical trials, involving a total of 4747 patients, were identified. A meta-analysis showed that operating time was not significantly different between the 2 groups [WMD = 0.46, 95% confidence interval (95% CI): −55.68 to 56.60, P = .99], intraoperative blood loss in laparoscopic surgery group was less than conventional open surgery group (WMD = −64.66, 95% CI: −87.31 to 42.01, P < .01); No significant difference in the number of lymph node retrieved from postoperative pathologic specimens was found between the 2 groups (WMD = −0.75, 95% CI: −1.72 to 0.23, P = .14); Postoperative time to flatus in laparoscopic surgery group was earlier than that in open surgery significantly (WMD = −1.22, 95% CI: −1.53 to −0.91, P < .01). The cases of postoperative complications were significantly different between the 2 groups, which showed that the cases of laparoscopic surgery group were less than those of open surgery group [odds ratio (OR) = 0.62, 95% CI: 0.52∼0.72, P < .01]; Moreover, hospital stay of laparoscopic surgery group was shorter than that of open surgery that showed significant difference (WMD = −2.38, 95% CI:−3.30 to −1.46, P < .01).Conclusion:Short-term outcomes of laparoscopic surgery are superior than conventional open surgery that include more safety and feasibility, and is expected to be a standardization operation method for colorectal carcinoma.

Decreased Length of Stay After Laparoscopic Diaphragm Repair for Isolated Diaphragm Injury After Penetrating Trauma

“…In previous publications about elective surgeries, laparoscopy has demonstrated decreased complications such as SSIs and hospital LOS. 39 In contrast, our study demonstrated no difference in terms of complications including SSI. Similarly, Trejo-Avila et al 40 performed a singlecenter retrospective study and found no statistically significant difference in complications when comparing 19 patients who underwent laparoscopic surgery to 38 who underwent open surgery for both blunt and penetrating abdominal trauma.…”

Laparoscopic and open surgery in rectal cancer patients in Germany: short and long-term results of a large 10-year population-based cohort

“…Laparoscopy has been used increasingly over the past years, but data regarding the oncologic resection quality compared to open surgery are still scarce. This study aimed to the Very positive short-term effects and immediate advantages of the laparoscopic approach are described in various publications, such as reduced blood loss [19][20][21][22][23][24][25][26], shorter hospitalization time [20][21][22][23][24][25][26][27][28][29][30][31][32], faster bowel movement recovery [20,22,24,25,33], fewer complications [14, 19-21, 28, 34], a better view in the low pelvic area [21,26,35,36], and a lower short-term mortality rate [28,34,37]; however, negative elements such as increased operation time [19,[22][23][24][25][30][31][32] and higher costs [25] have also been reported. The prolonged operation time for laparoscopy seems to be due to the degree of experience, as there was no significant difference in a Chinese study where all patients were treated by the ...…”

A meta-analysis of laparoscopic surgery versus conventional open surgery in the treatment of colorectal cancer

“…Our study have the similar conclusion with other searches. [34,35] Besides, laparoscopic surgery group significantly decreased the incidence of postoperative complication compared with the open surgery group.…”

“…There were some similar meta-analyses of open surgery versus laparoscopic surgery for patients with colorectal cancer. Tong et al [34] summarized 9 clinical trials and supported that laparoscopic surgery appears to be a better alternative therapy for patients with colorectal cancer as compared to the open surgery. Zhang et al [35] summarized fifteen publications which were published between 2007 and 2017, and reported that hand-assisted laparoscopic surgery (HALS) was associated with shorter hospital days, postoperative hospital duration and so on.…”