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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 4/2011

01-04-2011 | Original Article

Laparoscopic-assisted versus open surgery for rectal cancer: a meta-analysis of randomized controlled trials on oncologic adequacy of resection and long-term oncologic outcomes

Authors: Mei-Jin Huang, Jing-Lin Liang, Hui Wang, Liang Kang, Yan-Hong Deng, Jian-Ping Wang

Published in: International Journal of Colorectal Disease | Issue 4/2011

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Abstract

Background

Whether laparoscopic-assisted surgery (LS) can achieve the same oncologic outcomes compared with open surgery (OS) for rectal cancer remains controversial. The aim of this meta-analysis of randomized controlled trials (RCTs) is to compare oncologic adequacy of resection and long-term oncologic outcomes of LS with OS in the treatment of rectal cancer.

Methods

Literature searches of electronic databases (Pubmed, Embase, Web of Science, and Cochrane Library) and manual searches were performed to identify RCTs comparing values of oncologic adequacy of resection, recurrence, and survival following LS and OS.

Results

Six RCTs enrolling 1,033 participants were included in the meta-analysis. LS was associated with similar number of lymph nodes harvested and a similar distal tumor-free margin. LS was associated with a slightly high circumferential resection margin (CRM) positive rate with no significant difference (7.94% vs. 5.37%; risk ratio [RR], 1.13; P = 0.63). There was no significant difference between the two groups in local recurrence (RR, 0.55; P = 0.21). The 3-year overall survival advantage for LS over OS was not statistically significantly different (hazard ratio [HR], 0.76; P = 0.11). The 3-year disease-free survival was not significantly different between the two groups (HR, 1.16; P = 0.64).

Conclusions

The meta-analysis suggests that there are no differences between laparoscopic-assisted and open surgery in terms of number of lymph nodes harvested, involvement of CRM, local recurrence, 3-year overall survival, and disease-free survival for rectal cancer. However, more high-quality studies are needed for further analysis due to the small number of included studies.
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Metadata
Title
Laparoscopic-assisted versus open surgery for rectal cancer: a meta-analysis of randomized controlled trials on oncologic adequacy of resection and long-term oncologic outcomes
Authors
Mei-Jin Huang
Jing-Lin Liang
Hui Wang
Liang Kang
Yan-Hong Deng
Jian-Ping Wang
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 4/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-1091-6

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