摘要
Abstract
Objective To compare the clinical efficacy of laparoscopic versus open surgery with anal sphincter preservation for mid-low rectal cancer.Methods Databases of Pubmed,Embase,Cochrane library,CNKI and WanFan from inception to October 2017 were searched to retrieve randomized controlled trials (RCTs) about comparison of laparoscopic surgery to open surgery with anal sphincter preservation for mid-low rectal cancer.Meta-analysis was performed with RevMan5.3 software.Results Eleven RCTs involving 1090 patients were finally included.Compared with open surgery group,the laparoscopic surgery group had lower intraoperative blood loss (MD=-58.7,95％CI:-76.94～-40.42,P＜0.01) and incidence of overall postoperative complications(RR=0.51,95％CI:0.35～0.73,P＜0.01),had shorter time of bowel function recovery (MD=-1.30,95％CI:-1.52～-1.07,P＜0.01) and length of hospital stay (MD=-3.94,95％CI:-5.69～-2.20,P＜0.01).There were no statistical differences in the operative time(MD=9.48,95％CI:-9.75～28.7,P＞0.05),number of removed lymph nodes (MD=-0.98,95％CI:-2.83～0.86,P＞0.05),local recurrence rate(RR=0.S9,95％CI:0.34～1.02,P＞0.05),distant metastasis rate (RR=0.75,95％CI:0.35～1.62,P＞0.05),1-year overall survival rate (RR=1.06,95％CI:0.94～1.19,P＞0.05) and 5-year overall survival rate (RR=1.06,95％ CI:0.83～1.36,P＞0.05) between two groups.Conclusion Laparoscopic surgery with anal sphincter preservation has advantage of rapid postoperative recovery,less total complications and shorter hospital stay,which is safe and feasible for mid-low rectal cancer.关键词
中低位直肠癌/腹腔镜/Meta分析Key words
Mid-low rectal cancer/Laparoscopy/Meta-analysis
