Prognosis Comparisons of Laparoscopy versus Open Surgery for Rectal Cancer Patients after Preoperative Chemoradiotherapy: A Meta-Analysis

Abstract

<b><i>Aim:</i></b> We aimed to compare the oncological outcomes of laparoscopy and open resection for patients with rectal cancer following neoadjuvant chemoradiotherapy (NCRT). <b><i>Methods:</i></b> We searched the publications that compared the efficacy of laparoscopic surgery and open thoracotomy in treatment outcomes of rectal cancer after NCRT. All trials analyzed the summary hazard ratios of the endpoints of interest, including survival and individual postoperative complications. <b><i>Results:</i></b> Totally, 10 trials met our inclusion criteria. The pooled analysis of 3-year disease-free survival (OR 1.39, 95% CI 0.93–2.06; <i>p</i> = 0.11) and 3-year overall survival (OR 1.01, 95% CI 0.70–1.45; <i>p</i> = 0.97) showed that laparoscopic surgery did not achieve beneficial effects compared with open thoracotomy. The pooled result of duration of surgery indicated that laparoscopic surgery was associated with a trend for longer surgery time (SMD 27.53, 95% CI 1.34–53.72; <i>p</i> = 0.04), shorter hospital stay (SMD –1.64, 95% CI –2.70 to –0.58; <i>p</i> = 0.002), more postoperative complications (OR 0.77, 95% CI 0.60–0.99; <i>p</i> = 0.04), and decreased blood loss (SMD –49.87, 95% CI –80.61 to –19.14; <i>p</i> = 0.001). However, the number of removed lymph nodes, positive circumferential resection margin, as well as complications after surgery showed significant differences between the 2 groups. <b><i>Conclusions:</i></b> We focused on current evidence and reviewed the studies indicating that similar oncological outcomes were associated with laparoscopic surgery following NCRT for patients with locally advanced lower rectal cancer in comparison with open surgery.

[Retracted] Study on Ultrasonographic Diagnosis and Postoperative Comprehensive Nursing of Rectal Cancer in Preoperative Staging

“…The clinical symptom of inchoate patient of rectum cancer is not apparent, which just appears when canceration breaks ulcerate to form ulcer or infection. Symptoms are often shown as frequent defecation, habits change, tenesmus abdominal pain, stool deformation, abdominal distension, stool surface with blood and mucus, its incidence of malignant tumors in the third place, and there is a trend of increasing year by year [ 1 ]. Operation-based comprehensive treatment is the main treatment for rectal cancer.…”

Efficacy of Laparoscopic Radical Resection Combined with Neoadjuvant Chemotherapy and Its Impact on Long-Term Prognosis of Patients with Colorectal Cancer

“…CC is characterized by a high mortality rate. According to clinically related statistical studies, CC is second only to gastric cancer and esophageal cancer among digestive system malignant tumors in terms of the incidence and mortality [ 4 ]. Currently, the surgery is the mainstay of clinical treatment for CC.…”