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International Journal of Colorectal Disease

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01-03-2016 | Original Article

Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery

Authors: Jun-hua Zhao, Jing-xu Sun, Xuan-zhang Huang, Peng Gao, Xiao-wan Chen, Yong-xi Song, Jing Liu, Cheng-zhe Cai, Hui-mian Xu, Zhen-ning Wang

Published in: International Journal of Colorectal Disease | Issue 3/2016

Abstract

Background

Laparoscopic methods and fast-track surgery (FTS) can enhance recovery and reduce postoperative hospital stay. However, whether laparoscopic surgery can provide short-term benefits within FTS is controversial. Thus, we conducted a meta-analysis of published studies to evaluate the effect of laparoscopic colorectal surgery within FTS.

Methods

We searched PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies. Endpoints were duration of postoperative hospital stay, time to first bowel movement, total postoperative complication rate, readmission rate, mortality within 30 days after surgery, and conversation rate of laparoscopic surgery.

Results

Four randomized controlled trials and six clinical controlled trials (1510 patients) were eligible for analyses. Duration of postoperative hospital stay (weighted mean difference, –1.65 days; p < 0.001), time to first bowel movement (–1.13 days; p < 0.001), total postoperative complication rate (risk ratio [RR], 0.65; p < 0.001), readmission rate (0.46; p < 0.001), and mortality (0.45; p < 0.001) were significantly reduced in the laparoscopic surgery group. Overall conversion rate of laparoscopic surgery was 11.1 %. Subgroup analyses based on each FT element demonstrated that studies without the element “prevention of hypothermia,” “no bowel preparation,” or “no routine use of drains” did not show significant differences between two groups with regard to duration of postoperative hospital stay or total prevalence of postoperative complications.

Conclusion

Within FTS, laparoscopic methods can significantly shorten postoperative hospital stay, accelerate postoperative recovery, and enhance safety in colorectal surgery. The FT elements “prevention of hypothermia,” “no bowel preparation,” and “no routine use of drains” may play important parts in the combined effect of these two methods.

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Title: Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery
Authors: Jun-hua Zhao
Jing-xu Sun
Xuan-zhang Huang
Peng Gao
Xiao-wan Chen
Yong-xi Song
Jing Liu
Cheng-zhe Cai
Hui-mian Xu
Zhen-ning Wang
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 3/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2493-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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