Karanikolic Aleksandar, Golubovic Ilija, Radojkovic Milan, Pavlovic Milorad, Sokolovic Dusan, Kovacevic Predrag
General Surgery Clinic, Clinical Center Nis, Nis, Serbia.
J BUON. 2018 Mar-Apr;23(2):302-311.
The purpose of this meta-analysis was to evaluate differences between laparoscopic and open surgery and also the development of local and distant colorectal cancer (CRC) recurrences in treated patients.
2,058 cases treated with laparoscopic surgery and 2,365 cases with open surgery from 20 included studies were analyzed, using the random-effects model. The mean difference and odds ratio (OR) with 95% confidence interval (95%CI) were calculated. An overall and a subgroup analysis was performed according to the type of cancer - colon or rectal, and we registered the operating time, number of dissected lymph nodes and need for intraoperative blood transfusion in the laparoscopic and open surgery group of patients.
The operating time in the laparoscopic surgery group was significantly longer than in the open surgery group (mean difference 38.23 min). There was no significant differences in the number of dissected lymph nodes between the two groups when we pooled data for treatment of CRC (p=0.16). The OR of overall and local recurrences was significantly decreased in patients in the laparoscopic surgery group compared to those in the open surgery group (OR 0.83; 95%CI 0.70-0.98; p=0.03) and (OR 0.70; 95%CI 0.50-0.97; p=0.03), respectively. No significant differences were found between patients who underwent laparoscopic surgery and those that had open surgery for distant recurrences after CRC treatment.
There was statistically significant difference between laparoscopic or open surgery and development of local and overall CRC recurrences.
本荟萃分析旨在评估腹腔镜手术与开放手术之间的差异，以及接受治疗患者中局部和远处结直肠癌（CRC）复发的情况。
使用随机效应模型，对20项纳入研究中的2058例接受腹腔镜手术的病例和2365例接受开放手术的病例进行分析。计算平均差和比值比（OR）以及95%置信区间（95%CI）。根据癌症类型（结肠癌或直肠癌）进行总体和亚组分析，并记录腹腔镜手术组和开放手术组患者的手术时间、清扫淋巴结数量以及术中输血需求。
腹腔镜手术组的手术时间明显长于开放手术组（平均差38.23分钟）。当汇总CRC治疗数据时，两组之间清扫淋巴结数量无显著差异（p = 0.16）。与开放手术组患者相比，腹腔镜手术组患者总体复发和局部复发的OR均显著降低（分别为OR 0.83；95%CI 0.70 - 0.98；p = 0.03）和（OR 0.70；95%CI 0.50 - 0.97；p = 0.03）。CRC治疗后远处复发方面，接受腹腔镜手术的患者与接受开放手术的患者之间未发现显著差异。
腹腔镜手术或开放手术与局部和总体CRC复发的发生之间存在统计学显著差异。
