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The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aim of the study was to compare short- and long-term outcomes of laparoscopic surgery and conventional open surgery for colorectal cancer.

Methods

Published randomized controlled trial (RCT) reports of laparoscopic surgery and open surgery for colorectal cancer were searched, and short- and long-term factors were extracted to perform meta-analysis.

Results

A total of 15 RCT reports (6,557 colorectal cancer patients) were included in this study. Blood loss of laparoscopic surgery was less by 91.06 ml than open surgery (p = 0.044). Operation time was longer by 49.34 min (p = 0.000). The length of hospital stay was shorter by 2.64 days (p = 0.003). Incisional length was shorter by 9.23 cm (p = 0.000). Fluid intake was shorter by 0.70 day (p = 0.001). Bowel movement was earlier by 0.95 day (p = 0.000). Incidence of complications, blood transfusion, and 30 days death were significantly lower in laparoscopic surgery than in open surgery (p = 0.011, 0.000, 0.01). But there was no significant difference in lymph nodes (p = 0.535) and anastomotic leak (p = 0.924). There was also no significant difference in 3 and 5 years overall survival (p = 0.298, 0.966), disease-free survival (p = 0.487, 0.356), local recurrence (p = 0.270, 0.649), and no difference in 5 years distant recurrence (p = 0.838).

Conclusions

Laparoscopic surgery is a mini-injured approach which can cure colorectal cancer safely and radically, and it is not different from conventional open surgery in long-term effectiveness, so laparoscopic surgery can be tried to widely use in colorectal cancer.

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References

  1. Ohtani H, Tamamori Y, Azuma T et al (2011) A meta-analysis of the short-and long-term results of randomized controlled trials that compared laparoscopy-assisted and conventional open surgery for rectal cancer. J Gastrointest Surg 15(8):1375–1385

    Article  PubMed  Google Scholar 

  2. Jacobs M, Verdeja J, Goldstein H (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc Per Tech 1(3):144–150

    CAS  Google Scholar 

  3. Guillou PJ, Quirke P, Thorpe H et al (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472):1718–1726

    Article  PubMed  Google Scholar 

  4. Lord SA, Larach SW, Ferrara A et al (1996) Laparoscopic resections for colorectal carcinoma. Dis Colon Rectum 39(2):148–154

    Article  CAS  PubMed  Google Scholar 

  5. Lacy AM, García-Valdecasas JC, Delgado S et al (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359(9325):2224–2229

    Article  PubMed  Google Scholar 

  6. Milsom JW, Böhm B, Hammerhofer KA et al (1998) A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187(1):46–54

    Article  CAS  PubMed  Google Scholar 

  7. Braga M, Frasson M, Zuliani W et al (2010) Randomized clinical trial of laparoscopic versus open left colonic resection. Br J Surg 97(8):1180–1186

    Article  CAS  PubMed  Google Scholar 

  8. Fujii S, Ota M, Ichikawa Y et al (2010) Comparison of short, long-term surgical outcomes and mid-term health-related quality of life after laparoscopic and open resection for colorectal cancer: a case-matched control study. Int J Colorectal Dis 25(11):1311–1323

    Article  PubMed  Google Scholar 

  9. Gong J, Shi D-B, Li X-X et al (2012) Short-term outcomes of laparoscopic total mesorectal excision compared to open surgery. World J Gastroenterol WJG 18(48):7308

    Article  Google Scholar 

  10. Green B, Marshall H, Collinson F et al (2013) Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100(1):75–82

    Article  CAS  PubMed  Google Scholar 

  11. Jayne D, Thorpe H, Copeland J et al (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97(11):1638–1645

    Article  CAS  PubMed  Google Scholar 

  12. Jayne DG, Guillou PJ, Thorpe H et al (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25(21):3061–3068

    Article  PubMed  Google Scholar 

  13. Jeng Y-M (2007) Oncologic results of laparoscopic versus conventional open surgery for stage II or III left-sided colon cancers: a randomized controlled trial. Ann Surg Oncol 14(1):109–117

    PubMed  Google Scholar 

  14. Lacy AM, Delgado S, Castells A et al (2008) The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg 248(1):1–7

    Article  PubMed  Google Scholar 

  15. Nelson HSD, Wieand HS et al (2004) Laparoscopically assisted colectomy is as safe and effective as open colectomy in people with colon cancer Abstracted from: Nelson H, Sargent D, Wieand HS, et al.; for the Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059, Cancer Treat Rev 30(8):707–709

    Article  CAS  Google Scholar 

  16. Neudecker J, Klein F, Bittner R et al (2009) Short-term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer. Br J Surg 96(12):1458–1467

    Article  CAS  PubMed  Google Scholar 

  17. Pappas-Gogos G, Tellis C, Lasithiotakis K et al (2013) Oxidative stress markers in laparoscopic versus open colectomy for cancer: a double-blind randomized study. Surg Endosc 27(7):2357–2365

    Article  PubMed  Google Scholar 

  18. Park IJ, Choi G-S, Lim K-H et al (2009) Laparoscopic resection of extraperitoneal rectal cancer: a comparative analysis with open resection. Surg Endosc 23(8):1818–1824

    Article  PubMed  Google Scholar 

  19. Schwandner O, Schiedeck T, Killaitis C et al (1999) A case–control-study comparing laparoscopic versus open surgery for rectosigmoidal and rectal cancer. Int J Colorectal Dis 14(3):158–163

    Article  CAS  PubMed  Google Scholar 

  20. van der Pas MH, Haglind E, Cuesta MA et al (2013) Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol 14:210–218

    Article  PubMed  Google Scholar 

  21. Chan AC, Poon JT, Fan JK et al (2008) Impact of conversion on the long-term outcome in laparoscopic resection of colorectal cancer. Surg Endosc 22(12):2625–2630

    Article  PubMed  Google Scholar 

  22. Park JS, Choi G-S, Jun SH et al (2013) Long-term outcomes after laparoscopic surgery versus open surgery for rectal cancer: a propensity score analysis. Ann Surg Oncol 20:2633–2640

    Article  PubMed  Google Scholar 

  23. Choi YS, Lee S-I, Lee T-G et al (2007) Economic outcomes of laparoscopic versus open surgery for colorectal cancer in Korea. Surg Today 37(2):127–132

    Article  PubMed  Google Scholar 

  24. Park J-S, Kang S-B, Kim S-W et al (2007) Economics and the laparoscopic surgery learning curve: comparison with open surgery for rectosigmoid cancer. World J Surg 31(9):1827–1834

    Article  PubMed  Google Scholar 

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Conflict of interest

This article was supported by grants from the Medical Science Foundation of health ministry in Dalian city (no.2013-80).

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Authors and Affiliations

  1. The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116021, People’s Republic of China

    Chun-Li Wang, Gang Qu & Hong-Wei Xu

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  1. Chun-Li Wang
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  2. Gang Qu
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  3. Hong-Wei Xu
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Corresponding author

Correspondence to Hong-Wei Xu.

Additional information

Chun-Li Wang and Gang Qu contributed equally to this work.

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Wang, CL., Qu, G. & Xu, HW. The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis. Int J Colorectal Dis 29, 309–320 (2014). https://doi.org/10.1007/s00384-013-1827-1

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  • DOI: https://doi.org/10.1007/s00384-013-1827-1

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