Meta-analysis Of The Comparison Of Short-term Efficacy And Long-term Prognosis Between Laparoscopic Surgery And Open Surgery For Rectal Cancer

Objective: To compare the clinical effects of laparoscopic surgery(LS)and open surgery(OS)on rectal cancer.Methods: Published studies related to “rectal cancer” & “laparoscopy surgery” & “open surgery” were searched from MEDLINE,PubMed,Cochrane Library,CNKI,Chinese Biomedical Literature Database,Wan Fang Database and VIP Database,studies with short-term outcome and long-term outcome were involved in the meta-analysis.Data analysis was performed with RevMan5.3 from Cochrane Cooperation Net.Results: 28 articles were included in this Meta-analysis(n=7332 patients),and 2935 cases in laparoscopy surgery(LS)group,3497 cases in the open surgery(OS)group.Compared with OS,LS has no significantly different(RR=0.97,P=0.42>0.05)in age,gender,BMI and cancer-stage(TNM).Analyze the curative effect of recent surgery(including average operation time,intraoperative injury,anastomotic fistula formation,reoperation rate,recovery time needed for eating,average hospitalization days,30-day mortality,and surgical complications,etc.),the LS has obvious advantages in the short-term outcome in rectal cancer patients.At the same time LS vs OS for long-term prognosis of patients with rectal cancer(rectal cancer recurrence,5-year overall survival and 5-year disease-free survival rate),the LS has no significance: LS vs OS 5-year disease-free surial rate(RR = 1.24,P = 0.06>0.05).LS vs OS 5-years overall survival rate(RR = 1.13,P = 0.24>0.05).LS vs OS 5-years postoperative recurrence(RR = 0.71,P = 0.06>0.05).Existing data shows that the LS long-term prognosis in rectal cancer has no obvious differences with OS.Conclusion: Compared with OS,in the short-term effects,LS complications less and mortality lower in patients with rectal cancer.However,there was no significance for the long-term outcomes.