HOU Songlin 1,2 , LIU Daizhi 1,2 , JIANG Xianhong 2 , LIAO Hailing 1 , YANG Song 1 , CHEN Xiaobo 2 , LI Lifa 2 , ZHANG Guangjun 1,2 , ZHOU Tong 1,2
  • 1. Institute of Hepatobiliary Pancreas and Intestinal Disease, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
  • 2. The Second Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
ZHOU Tong, Email: zhoutong0088@163.com
neoadjuvant chemoradiotherapy; laparoscopy; open surgery; rectal cancer; meta-analysis
10.7507/1007-9424.201711027
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective  To compare efficacy of laparoscopic surgery and open surgery in treatment of rectal cancer after neoadjuvant chemoradiotherapy. Methods  The relevant literatures were retrieved from databases including CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library, and Embase from 2007 to 2017, all the relevant randomized controlled trial (RCT) or non-randomized controlled trial (NRCT) of laparoscopic surgery versus open surgery in patients with rectal cancer were collected according to the inclusion and exclusion criterial. Two reviewers independently screened the literatures, extracted the data, and assessed the bias risk of the included studies. Then, the meta-analysis was performed using RevMan 5.3 software. Results  A total of 11 RCTs and 9 NRCTs involving 2 036 patients with rectal cancer were included, of these, including 1 021 cases of laparoscopic surgery and 1 015 cases of open surgery. The results of the meta-analysis showed that the operation time was increased ［WMD=14.21, 95% CI (1.92, 26.51)］, the intraoperative blood loss ［WMD=–38.96, 95% CI (–60.29, –7.63)］, first postoperative exhaust time ［WMD=–0.86, 95% CI (–1.14, –0.57)］, first postoperative intake food time ［WMD=–0.89, 95% CI (–1.15, –0.62)］, and postoperative hospitalization time ［WMD=–2.38, 95% CI (–3.44, –1.32)］ were reduced in the laparoscopic surgery as compared with the open surgery; the rate of the sphincter-saving was increased ［OR=2.35, 95% CI (1.67, 3.30)］, the rates of the local recurrence ［OR=0.25, 95% CI (0.13, 0.47)］, postoperative overall complications ［OR=0.34, 95% CI (0.26, 0.43)］, infection of incision ［OR=0.39, 95% CI (0.25, 0.62)］, intestinal obstruction ［OR=0.30, 95% CI (0.17, 0.53)］, lung infection ［OR=0.32, 95% CI (0.18, 0.57)］, and anastomotic fistula ［OR=0.40, 95% CI (0.22, 0.73)］ were decreased in the laparoscopic surgery as compared with the open surgery; the intraoperative lymph node resection ［WMD=–0.99, 95% CI (–2.11, 0.12)］, the rates of the 3-year disease-free survival ［OR=0.91, 95% CI (0.54, 1.54)］, pelvic infection ［OR=0.64, 95% CI (0.17, 2.45)］, anastomotic bleeding ［OR=0.54, 95% CI (0.22, 1.34)］, urinary retention ［OR=0.71, 95% CI (0.34, 1.48)］, and urinary tract infection ［OR=1.22, 95% CI (0.45, 3.30)］ had no significant differences between these two surgeries. Conclusion  Laparoscopy surgery is still safer, more effective, and more reliable than conventional open surgery after neoadjuvant chemoradiotherapy in rectal cancer, but it needs more clinical RCTs to further provide accurate and reliable results.

Citation： HOU Songlin, LIU Daizhi, JIANG Xianhong, LIAO Hailing, YANG Song, CHEN Xiaobo, LI Lifa, ZHANG Guangjun, ZHOU Tong. Comparison of clinical efficacy of laparoscopy and open surgeries for rectal cancer after neoadjuvant chemoradiotherapy in China: a meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(5): 578-591. doi: 10.7507/1007-9424.201711027 Copy

  • Previous Article

    Clinical analysis of left-sided appendicitis: report of 2 cases and review of 212 published cases

  • Next Article

    Correlation of adiponectin rs2241766 gene polymorphism and colorectal cancer: a meta-analysis