The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis

Abstract

Purpose: The aim of the study was to compare short- and long-term outcomes of laparoscopic surgery and conventional open surgery for colorectal cancer.

Methods: Published randomized controlled trial (RCT) reports of laparoscopic surgery and open surgery for colorectal cancer were searched, and short- and long-term factors were extracted to perform meta-analysis.

Results: A total of 15 RCT reports (6,557 colorectal cancer patients) were included in this study. Blood loss of laparoscopic surgery was less by 91.06 ml than open surgery (p = 0.044). Operation time was longer by 49.34 min (p = 0.000). The length of hospital stay was shorter by 2.64 days (p = 0.003). Incisional length was shorter by 9.23 cm (p = 0.000). Fluid intake was shorter by 0.70 day (p = 0.001). Bowel movement was earlier by 0.95 day (p = 0.000). Incidence of complications, blood transfusion, and 30 days death were significantly lower in laparoscopic surgery than in open surgery (p = 0.011, 0.000, 0.01). But there was no significant difference in lymph nodes (p = 0.535) and anastomotic leak (p = 0.924). There was also no significant difference in 3 and 5 years overall survival (p = 0.298, 0.966), disease-free survival (p = 0.487, 0.356), local recurrence (p = 0.270, 0.649), and no difference in 5 years distant recurrence (p = 0.838).

Conclusions: Laparoscopic surgery is a mini-injured approach which can cure colorectal cancer safely and radically, and it is not different from conventional open surgery in long-term effectiveness, so laparoscopic surgery can be tried to widely use in colorectal cancer.