The Safety Of Laparoscopic Total Colectomy And Open Total Colectomy Of IBD,FAP And STC:a Meta-analysis

Objective: To evaluate the safety of laparoscopic total colectomy and open total colectomy.Methods: The databases such as Pubmed, Embase, Cochrane Library, Web of Science, CNKI, VIP and Wan Fang data were searched to collect clinical trials from the date of their establishment to January 5, 2015. The literature limited in Chinese and English, and the references of the included studies were also retrieved.Studies were screened according to the inclusion and exclusion criteria data were extracted.The methodological quality of the included studies was assessed to Jadad score criterion, and meta-analyses were performed with the Rev Man 5.2 software. Results: There are a total of six studies involving 226 patients.The results show: the operation time: SMD=1.02,95%CI=[-0.04,2.09],P=0.06,Blood loss: SMD=-0.41,CI=[-0.68,-0.14], P=0.003. Postoperative exhaust time for the first time MD=-1.74, 95%CI=[-2.59,-0.88], P<0.00001.Hospitalization time: MD=-5.73, 95%CI=[-5.99,-4.75], P<0.00001. Incision complications: OR=0.53, 95%CI=[0.22,1.31],P=0.17. The length of incision: MD=-10.68,95%CI= [-10.95,-10.41],P<0.00001. The postoperative obstruction of intestinal: OR=0.40, 95%CI= [0.16, 1.00], P=0.05. Conclusion:Comparing with traditional open total colectomy, the laparoscopic can reduce postoperative time of intestinal function recovery,hospitalization days and blood loss.There is no statistical difference of the incision complications, operation time and fistula. So for the different patients, taking individualized treatment.