Wu Qingbin, Wei Mingtian, Ye Zengpanpan, Bi Liang, Zheng Erliang, Hu Tao, Gu Chaoyang, Wang Ziqiang
1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .
2 West China School of Medicine, Sichuan University , Chengdu, China .
J Laparoendosc Adv Surg Tech A. 2017 Oct;27(10):1038-1050. doi: 10.1089/lap.2017.0031. Epub 2017 Mar 29.
The surgical management of transverse colon cancer (TCC) is still not standardized. The aim of this meta-analysis was to evaluate the effect of laparoscopic colectomy (LC) for treatment of TCC in terms of short-term and long-term outcomes compared with open colectomy.
A systematic literature search with no limits was performed in PubMed and Embase. The last search was performed on September 15, 2016. The short-term outcomes included intraoperative outcomes, postoperative outcomes, and oncological surgical quality. The long-term outcomes included overall survival (OS) and disease-free survival (DFS).
Thirteen articles and one conference abstract published between 2010 and 2016 with a total of 1728 patients were enrolled in this meta-analysis. LC was associated with significant less estimated blood loss, fewer total postoperative complications, and shorter time to first flatus, time to liquid diet, length of hospital stay, and length of postoperative hospital stay. However, longer operative time was needed in LC. There was no statistically significant difference between the groups concerning the intraoperative complications, mortality, ileus, anastomotic leakage, bleeding, wound infection, abdominal infection, lymph nodes harvested, proximal resection margin, distal resection margin, OS, or DFS.
Our meta-analysis suggests that LC is a safe and feasible technique for TCC associated with less estimated blood loss, fewer total postoperative complications, quicker recovery of intestinal function, shorter length of hospital stay, and equivalent long-term outcomes. Furthermore, a large-scaled, prospective randomized controlled study is warranted to verify those results.
横结肠癌（TCC）的手术治疗仍未标准化。本荟萃分析的目的是评估与开放结肠切除术相比，腹腔镜结肠切除术（LC）治疗TCC的短期和长期效果。
在PubMed和Embase上进行了无限制的系统文献检索。最后一次检索于2016年9月15日进行。短期结果包括术中结果、术后结果和肿瘤外科质量。长期结果包括总生存期（OS）和无病生存期（DFS）。
本荟萃分析纳入了2010年至2016年间发表的13篇文章和1篇会议摘要，共1728例患者。LC与估计失血量显著减少、术后总并发症更少以及首次排气时间、流食时间、住院时间和术后住院时间更短相关。然而，LC需要更长的手术时间。两组在术中并发症、死亡率、肠梗阻、吻合口漏、出血、伤口感染、腹腔感染、淋巴结清扫、近端切缘、远端切缘、OS或DFS方面无统计学显著差异。
我们的荟萃分析表明，LC是一种安全可行的治疗TCC的技术，其估计失血量更少、术后总并发症更少、肠道功能恢复更快、住院时间更短且长期效果相当。此外，有必要进行大规模的前瞻性随机对照研究来验证这些结果。
