Department of Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, 600 Yishan Road, 200233, Shanghai, People's Republic of China.
Med Oncol. 2011 Dec;28(4):925-33. doi: 10.1007/s12032-010-9549-5. Epub 2010 May 11.
The aim of this study was to compare the outcome of the overall complication, mortality, and recurrence rate between laparoscopic resection and open surgery for colorectal cancer. We searched the Medline, Embase, and Cochrane Library and systematically reviewed the randomized controlled trials by comparing the overall complication, mortality, and recurrence rate between laparoscopic resection and open surgery for colorectal cancer. Fifteen trials with 4,207 patients who reported long-term outcomes of the overall complication, mortality, and recurrence rate were included. The combined results of the individual trials showed no statistically significant difference in the odds ratio (OR) for overall recurrence (OR 0.92, 95% CI, 0.77-1.11, P=0.34), local recurrence (OR 0.81, 95% CI, 0.59-1.12, P=0.20), distant metastasis (OR 1.01, 95% CI, 0.78-1.30, P=0.95), wound-site recurrence (OR 1.97, 95% CI, 0.77-5.02, P=0.16), colorectal cancer-related mortality (OR 0.82, 95% CI, 0.66-1.02, P=0.07), colon cancer-related mortality (OR 0.85, 95% CI, 0.66-1.09, P=0.20), rectal cancer-related mortality (OR 0.76, 95% CI, 0.53-1.11, P=0.16), and overall mortality (OR 0.87, 95% CI, 0.73-1.73, P=0.11) between the laparoscopic surgery and open surgery groups. The overall complications in the laparoscopic surgery group were much lower than that in the open surgery group (OR 0.71, 95% CI, 0.58-0.87, P=0.001). This meta-analysis showed that the successful laparoscopic colorectal resection for colorectal cancer was as effective as open surgery in terms of the oncological outcomes, thereby suggesting that laparoscopic surgery can be continued in patients with colorectal cancer.
本研究旨在比较腹腔镜与开腹结直肠癌手术的总体并发症、死亡率和复发率。我们检索了 Medline、Embase 和 Cochrane 图书馆，并通过比较腹腔镜与开腹结直肠癌手术的总体并发症、死亡率和复发率，对随机对照试验进行了系统综述。纳入了 15 项研究，共 4207 例患者报告了总体并发症、死亡率和复发率的长期结果。个体试验的综合结果显示，总体复发（OR 0.92，95%CI，0.77-1.11，P=0.34）、局部复发（OR 0.81，95%CI，0.59-1.12，P=0.20）、远处转移（OR 1.01，95%CI，0.78-1.30，P=0.95）、切口部位复发（OR 1.97，95%CI，0.77-5.02，P=0.16）、结直肠癌相关死亡率（OR 0.82，95%CI，0.66-1.02，P=0.07）、结肠癌相关死亡率（OR 0.85，95%CI，0.66-1.09，P=0.20）、直肠癌相关死亡率（OR 0.76，95%CI，0.53-1.11，P=0.16）和总体死亡率（OR 0.87，95%CI，0.73-1.73，P=0.11）两组间无统计学差异。腹腔镜手术组的总体并发症明显低于开腹手术组（OR 0.71，95%CI，0.58-0.87，P=0.001）。这项荟萃分析表明，对于结直肠癌患者，成功的腹腔镜结直肠切除术与开腹手术在肿瘤学结果方面同样有效，因此可以继续在结直肠癌患者中使用腹腔镜手术。
