Laparoscopic versus open colorectal resection for cancer: a meta-analysis of results of randomized controlled trials on recurrence

Abstract

Aims: Laparoscopic resection for colorectal cancer remains controversial. This is because it is uncertain whether recurrence rates after laparoscopic-assisted surgery is comparable to those reported after open surgery. We performed a meta-analysis of the published literature in an attempt to answer this question.

Methods: Eligible articles were identified by searches of MEDLINE, EMBase and the Cochrane database. Prospective randomized clinical trials were eligible if they included patients with colorectal cancer treated by laparoscopic surgery versus open surgery and followed for recurrence.

Results: Ten trials with information on disease recurrence on 2474 patients were included. In the combined results, no statistically significant difference in the OR for overall recurrence between the laparoscopic surgery and open surgery group was found (OR 0.93, 95% CI 0.71-1.21, P=0.58). Stratified by recurrence type, the combined results of the individual reports show no statistically significant difference for local recurrence (OR 0.80, 95% CI 0.50-1.29, P=0.36), distant metastases (OR 0.90, 95% CI 0.62-1.29, P=0.56) and port or wound-site recurrence (OR 1.04, 95% CI 0.18-6.03, P=0.97) between the two surgical techniques.

Conclusion: This meta-analysis supports that the recurrence rates for patients with colorectal cancer treated by laparoscopic surgery do not differ from those for open surgery. Longer follow-up studies will further define outcomes, comparing the two techniques in the treatment of colorectal cancer.