Jun Li1, Ke-feng Ding, Su-zhan Zhang. 1. Department of Surgical Oncology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China.
Abstract
OBJECTIVE: To evaluate the short-term curative effects and safety of laparoscopic resection (LR) in treatment of colorectal cancer. METHODS: The databases PubMed, Embase, CCTR, and CBMdisc were retrieved and 15 medical journals published in different countries were retrieved manually to search the literatures related to randomized controlled trials (RCTs) on the comparison between the effects and safety of LR and open resection (OR) in treatment of colorectal cancer that were published before the end of 2005. After selected based on the inclusion and exclusion standards, the valid literature were appraised by 2 reviewers independently. RESULTS: Nine articles, with a mean quality score of 7.6 +/- 0.6 were included into the meta-analysis. The baseline characteristics of the LR group were similar to those of the OR group. In comparison with the OR group, the incision length of the LR group was shorter by 12 cm [95% CI (-13.51, -10.49), P < 0.01], blood loss was less by 75 ml [95% CI (-86.06, -62.99), P < 0.01], intensity of pain in the first day after operation was lower [weight mean deviation = -0.80, 95% CI (-1.26, -0.34), P < 0.01], parenteral narcotic requirement was lower [standard mean deviation = -0.31, 95% CI (-0.42, -0.21), P < 0.01], and average times before the post-operative first flatus, first bowel movement, and diet resumption, and discharge were all shorter (all P < 0.05); however, the operation time was longer by 42 min [95% CI (32.18, 52.50), P < 0.01]. There were no significant differences in the length of resected specimen, positive rate of resection margin, number of retrieved lymph nodes, and morbidity rates of intra-operative and post-operative complications. CONCLUSION: With faster recovery and less pain compared with OR, LR is safe and effective in the treatment of colorectal cancer.
OBJECTIVE: To evaluate the short-term curative effects and safety of laparoscopic resection (LR) in treatment of colorectal cancer. METHODS: The databases PubMed, Embase, CCTR, and CBMdisc were retrieved and 15 medical journals published in different countries were retrieved manually to search the literatures related to randomized controlled trials (RCTs) on the comparison between the effects and safety of LR and open resection (OR) in treatment of colorectal cancer that were published before the end of 2005. After selected based on the inclusion and exclusion standards, the valid literature were appraised by 2 reviewers independently. RESULTS: Nine articles, with a mean quality score of 7.6 +/- 0.6 were included into the meta-analysis. The baseline characteristics of the LR group were similar to those of the OR group. In comparison with the OR group, the incision length of the LR group was shorter by 12 cm [95% CI (-13.51, -10.49), P < 0.01], blood loss was less by 75 ml [95% CI (-86.06, -62.99), P < 0.01], intensity of pain in the first day after operation was lower [weight mean deviation = -0.80, 95% CI (-1.26, -0.34), P < 0.01], parenteral narcotic requirement was lower [standard mean deviation = -0.31, 95% CI (-0.42, -0.21), P < 0.01], and average times before the post-operative first flatus, first bowel movement, and diet resumption, and discharge were all shorter (all P < 0.05); however, the operation time was longer by 42 min [95% CI (32.18, 52.50), P < 0.01]. There were no significant differences in the length of resected specimen, positive rate of resection margin, number of retrieved lymph nodes, and morbidity rates of intra-operative and post-operative complications. CONCLUSION: With faster recovery and less pain compared with OR, LR is safe and effective in the treatment of colorectal cancer.