摘要
Abstract
Objective:To conduct a meta-analysis evaluating the feasibility and efficacy of laparoscopic surgery (LS) versus open surgery (OS) for advanced rectal cancer after neoadjuvant chemoradiotherapy (NCRT).Methods:The PubMed,Embase and the Cochrane Library were electronically searched.Randomized controlled trials (RCTs) and non-randomized controlled trials (n-RCTs) published in English comparing the outcomes of LS versus OS for advanced rectal cancer with NCRT were identified.RevMan 5.3 software was used for this meta-analysis.Results:Two RCTs and seven n-RCTs totaling 1 338 patients (LS=691,OS=647)were analyzed.Meta-analysis showed that there were no significant differences in pathology results:positive circumferential resection margin [odds ratio (OR)=1.24,95%CI:0.74~2.08,P=0.42] and the number of lymph nodes harvested [weighted mean difference (WMD)=-0.35,95%CI:-1.48~0.78,P=0.54] between LS and OS for advanced rectal cancer after NCRT.LS was associated with significantly delayed operative time (WMD=26.26,95%CI:4.59~47.92,P=0.02),less blood loss (WMD=-46.48,95%CI:-72.85~-20.11,P=0.0006),shorter length of hospital stay (WMD:-1.80,95%CI:-2.85~-0.74,P=0.0009) and fewer postoperative complications (OR=0.77,95%CI:0.60~0.99,P=0.04).There was no significant difference in the reoperation (OR=1.30,95%CI:0.61~2.77,P=0.49) between LS and OS for advanced rectal cancer after NCRT.Conclusions:LS versus OS for advanced rectal cancer after NCRT is proved to be safe and effective in the short-term treatment and pathology results.关键词
直肠肿瘤/新辅助放化疗/腹腔镜检查/剖腹术/Meta分析Key words
Rectal neoplasms/Neoadjuvant chemoradiotherapy/Laparoscopy/Laparotomy/Meta-analysis分类
医药卫生
