Gao Feng, Cao Yun-Fei, Chen Li-Sheng
Department of Coloproctological Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
Int J Colorectal Dis. 2006 Oct;21(7):652-6. doi: 10.1007/s00384-005-0079-0. Epub 2006 Feb 7.
Laparoscopic resection (LR) has become increasingly popular for the management of rectal cancer. Despite a decade of experience, the safety and efficacy of LR for rectal cancer remains to be established. This report performs a meta-analysis to compare LR with conventional open resection (CR) in patients with rectal cancer.
Using a defined search strategy, studies directly comparing CR with LR for rectal cancer were identified. The data for patients with rectal cancer treated with both approaches were extracted and used in our meta-analysis. Open surgery and laparoscopic surgery were compared in terms of postoperative mortality, morbidity, complications, oncological clearance, operating time, and time before recovery to a normal diet.
Compared with CR, LR is associated with lower morbidity rates [OR 0.63 (0.41, 1.96) P=0.03], longer operating times [weighted mean difference 1.59 (1.20, 1.98) P<0.00001], similar mortality rates, wound healing disorder rates, urinary disorder rates, cardiopulmony disease rates, all leakage rates, all abscess rates and a positive rate of margin.
LR is associated with less postoperative morbidity, but longer operation time. A prospective randomized controlled trial is warranted to fully investigate these and other outcome measures.
腹腔镜切除术（LR）在直肠癌治疗中越来越受欢迎。尽管已有十年经验，但LR治疗直肠癌的安全性和有效性仍有待确定。本报告进行一项荟萃分析，比较直肠癌患者中LR与传统开放切除术（CR）。
采用既定检索策略，识别直接比较CR与LR治疗直肠癌的研究。提取两种方法治疗的直肠癌患者数据并用于我们的荟萃分析。比较开放手术和腹腔镜手术在术后死亡率、发病率、并发症、肿瘤清除率、手术时间以及恢复正常饮食前的时间方面的差异。
与CR相比，LR的发病率较低[比值比0.63（0.41，1.96），P = 0.03]，手术时间较长[加权平均差1.59（1.20，1.98），P < 0.00001]，死亡率、伤口愈合障碍率、泌尿系统疾病率、心肺疾病率、所有渗漏率、所有脓肿率及切缘阳性率相似。
LR术后发病率较低，但手术时间较长。有必要进行一项前瞻性随机对照试验以全面研究这些及其他结局指标。
