Department of Thyroid and Gastrointestinal Surgical Oncology, Shenyang Fifth People Hospital, Shenyang 110023, China.
Department of Obstetrics and Gynecology, Shenyang Yuhong District People's Hospital, Shenyang 110141, China.
Math Biosci Eng. 2019 May 23;16(5):4645-4659. doi: 10.3934/mbe.2019233.
The aim of this article is to compare the oncological outcomes of laparoscopic and open resection for colon cancer.
Search the publications on comparison the efficacy of laparoscopic surgery comparison with open surgery in treatment outcomes of colon cancer to May, 2018. After rigorous reviewing on quality, the data was extracted from eligible trials. All trials analyzed the summary hazard ratios (HRs) of the endpoints of interest, including intraoperative and postoperative outcomes.
A total of 13 trials were met our inclusion criteria. With the pooled result of duration of surgery indicate that laparoscopic surgery was associated with a trend longer operate time (SMD = 0.58, 95% CI 0.17-0.99; P＝0.005) , shorter length of hospital stay (SMD = -0.57, 95% CI -1.00--0.15; P = 0.008) and postoperative hospital stay (SMD = -0.66, 95% CI -0.99--0.33; P = 0.0001) , less blood loss (SMD = -0.68, 95% CI -1.12--0.24; P = 0.002), shorter incision length (SMD = -4.61, 95% CI -5.79--3.43; P＜＝0.00001 and less wound infection (OR = 0.30, 95% CI 0.13-0.67; P = 0.004). However, there were no differences in the number of lymph nodes harvested (P = 0.17), ileus (P = 0.91), pulmonary infection (P = 0.22) and postoperative complications (P = 0.24) between the 2 groups.
Laparoscopic surgery had similar intraoperative and postoperative recovery parameters to those of the patients in the open group. The patients treated with laparoscopic had a trend longer operate time, shorter hospital stays, less intra-operative blood loss, faster recovery and lower incidence of wound infection. Whether it can be expected to be a standardization operation method for colon carcinoma still need more random clinical trials to be verified.
本文旨在比较腹腔镜和开腹结直肠癌切除术的肿瘤学结果。
检索 2018 年 5 月前比较腹腔镜手术与开腹手术在结直肠癌治疗效果的文献。经过严格的质量评估后，从合格试验中提取数据。所有试验均分析了感兴趣终点的汇总风险比（HRs），包括围手术期结果。
共有 13 项试验符合纳入标准。手术时间的汇总结果表明，腹腔镜手术的手术时间有延长的趋势（SMD = 0.58，95%CI 0.17-0.99；P=0.005），住院时间（SMD = -0.57，95%CI -1.00--0.15；P=0.008）和术后住院时间（SMD = -0.66，95%CI -0.99--0.33；P=0.0001）更短，出血量（SMD = -0.68，95%CI -1.12--0.24；P=0.002）更少，切口长度（SMD = -4.61，95%CI -5.79--3.43；P＜0.00001）更短，伤口感染（OR = 0.30，95%CI 0.13-0.67；P=0.004）更少。然而，两组间淋巴结检出数量（P=0.17）、肠梗阻（P=0.91）、肺部感染（P=0.22）和术后并发症（P=0.24）无差异。
腹腔镜手术与开腹组患者的围手术期恢复参数相似。腹腔镜组患者的手术时间较长，住院时间较短，术中出血量较少，恢复较快，伤口感染发生率较低。是否可以期待腹腔镜成为结肠癌的规范化手术方法，仍需要更多的随机临床试验来验证。
