腹腔镜辅助直肠切除术（LARR）与开放式直肠切除术（ORR）治疗癌的组织病理学结果的荟萃分析。

Meta-analysis of histopathological outcomes of laparoscopic assisted rectal resection (LARR) vs open rectal resection (ORR) for carcinoma.

机构信息

South East Queensland Surgery (SEQS), Sunnybank Obesity Centre, Sunnybank, Queensland, Australia; School of Agricultural, Computing and Environmental Sciences, International Centre for Applied Climate Science, University of Southern Queensland, Toowoomba, Queensland, Australia; Mayne Medical School, School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; Faculty of Health and Social Science, Bolton University, Bolton, Lancashire, UK.

South East Queensland Surgery (SEQS), Sunnybank Obesity Centre, Sunnybank, Queensland, Australia.

出版信息

Am J Surg. 2018 Nov;216(5):1004-1015. doi: 10.1016/j.amjsurg.2018.06.012. Epub 2018 Jun 19.

DOI:10.1016/j.amjsurg.2018.06.012

PMID:29958656

Abstract

BACKGROUND

We conducted a meta-analysis of the randomized evidence to determine the relative merits of histopathological outcomes of laparoscopic assisted (LARR) versus open rectal resection (ORR) for rectal cancer.

DATA SOURCES

A search of PubMed and other electronic databases comparing LARR and ORR between Jan 2000 and June 2016 was performed. Histopathological variables analyzed included; location of rectal tumors; complete and incomplete TME; positive and negative circumferential resection margins (+/-CRM); positive distal resected margins (+DRM); distance of tumor from DRM; number of lymph nodes harvested; resected specimen length; tumor size and perforated rectum.

RESULTS

Fourteen RCTs totaling 3843 patients (LARR = 2096, ORR = 1747) were analyzed. Comparable effects were noted for all these histopathological variables except for the variable perforated rectum which favored ORR.

CONCLUSIONS

LARR compares favorably to ORR for rectal cancer treatment. However, there is significantly higher risk of rectal perforation during LARR compared to ORR.

摘要

背景

我们对随机对照试验进行了荟萃分析，以确定腹腔镜辅助（LARR）与开腹直肠切除术（ORR）治疗直肠癌的组织病理学结果的相对优势。

资料来源

检索 2000 年 1 月至 2016 年 6 月间比较 LARR 和 ORR 的 PubMed 和其他电子数据库。分析的组织病理学变量包括：直肠肿瘤的位置；完全和不完全 TME；阳性和阴性环周切缘（+/-CRM）；阳性远端切缘（+DRM）；肿瘤距 DRM 的距离；淋巴结采集数；切除标本长度；肿瘤大小和穿孔直肠。