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Clinical safety and outcomes of laparoscopic surgery versus open surgery for palliative resection of primary tumors in patients with stage IV colorectal cancer: a meta-analysis

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Abstract

Background

This study was performed to compare the clinical safety and outcomes of laparoscopic versus open surgery for primary tumors in patients with stage IV colorectal cancer.

Methods

Pertinent studies were selected from the MEDLINE, EMBASE, and Cochrane Library databases; references from published articles; and reviews. Both prospective and retrospective studies were included for the meta-analysis. Clinical outcomes included safety, complications, mortality, and survival.

Results

Six trials involving 1802 patients were included. The operative time was longer for laparoscopic than for open surgery (mean difference (MD) = 44.20, 95 % confidence interval (CI) 17.31–71.09, Z = 3.22, P = 0.001). Laparoscopic surgery was also associated with fewer postoperative complications (odds ratio 0.53, 95 % CI 0.37–0.78, Z = 3.29, P = 0.001) and less operative blood loss (MD = −65.40, 95 % CI −102.37 to −28.42, Z = 3.47, P = 0.0005). Median survival ranged from 11.4 to 30.1 months. The total hospital stay was 1.68 days shorter for laparoscopic than for open surgery (95 % CI −1.83 to −1.53, Z = 21.64, P < 0.00001).

Conclusion

Laparoscopic surgery for palliative resection of stage IV colorectal cancer is associated with better perioperative outcomes than open surgery.

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Acknowledgments

This work was supported by the Shanghai Young Physician Training Program .

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    Authors and Affiliations

    1. Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, 200040, Shanghai, China

      Min-Wei Zhou, Xiao-Dong Gu, Jian-Bin Xiang & Zong-You Chen

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    1. Min-Wei Zhou
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    2. Xiao-Dong Gu
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    Correspondence to Zong-You Chen.

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    Min-Wei Zhou, Xiao-Dong Gu, Jian-Bin Xiang, and Zong-You Chen have no conflicts of interest or financial ties to disclose.

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    Xiao-Dong Gu and Min-Wei Zhou contributed equally to this work and are considered co-first authors.

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    Zhou, MW., Gu, XD., Xiang, JB. et al. Clinical safety and outcomes of laparoscopic surgery versus open surgery for palliative resection of primary tumors in patients with stage IV colorectal cancer: a meta-analysis. Surg Endosc 30, 1902–1910 (2016). https://doi.org/10.1007/s00464-015-4409-1

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