摘要
Abstract
Objective:To evaluate the clinical efficacy of neoadjuvant chemotherapy combined with laparoscopic surgery in the treatment of colorectal cancer through a meta-analysis.Methods:The China national knowledge infrastructure,Wanfang,PubMed,and national center for biotechnology information were searched for controlled studies comparing neoadjuvant chemotherapy combined with laparoscopic surgery versus surgery alone for colorectal cancer,published up to Dec.2023.Two researchers independently collected li-terature content and extracted research data.Data analysis was performed using RevMan 5.4 software.Results:A total of 9 retrospective studies involving 850 patients with colorectal cancer were included,with 436 patients in the surgery alone(SG)group and 414 patients in the neoadjuvant chemotherapy combined with laparoscopic operation(CB)group.Compared with the SG group,the CB group had significantly shorter time to first flatus(MD=0.75,95％CI=0.40～1.10,P＜0.0001),shorter hospital stay(MD=2.87,95％CI=0.69～5.04,P=0.010),lower incidence of complications(OR=4.43,95％CI=2.76～7.11,P＜0.00001),and lower recurrence rate(OR=4.52,95％CI=2.53～8.08,P＜0.00001).The postoperative levels of carcinoembryonic antigen(MD=2.06,95％CI=0.63～3.49,P=0.005),CA19-9(MD=14.54,95％CI=4.12～24.96,P=0.006),and CA724(MD=0.92,95％CI=0.57～1.27,P＜0.00001)were significantly lower in the CB group.The 2-year survival rate in the CB group was higher than that in the SG group(OR=3.09,95％CI=1.25～7.61,P=0.01).There was no significant difference in operative time between the two groups(MD=6.13,95％CI=-17.42～29.68,P=0.61).Conclusions:Neoadjuvant chemotherapy combined with laparoscopic surgery is safe,reliable and effective for colorectal cancer,significantly reducing serum carcinoembryonic antigen,CA19-9 and CA724 levels,and is worthy of clinical promotion and application.关键词
结直肠肿瘤/腹腔镜检查/新辅助化疗/Meta分析Key words
Colorectal neoplasms/Laparoscopy/Neoadjuvant chemotherapy/Meta-analysis分类
医药卫生
