Meta-analysis Of Laparoscopic Versus Open Total Mesorectal Excision For Rectal Cancer

0bject: To evaluate whether there are any relevant differences in efficacy and safety after LTME, for the resection of rectal cancer, compared with OTME.Methods: We searched bibliographic databases in order to identify relevant primary studies from January 1995 to March 2010. We included randomized controlled trials (RCT) and non-randomized concurrent control trials. After selected based on the inclusion and exclusion standards, we fetched the characteristics of included studies, and finish the META-analysis finally.Results : 16 studies were included into the META-analysis. The basic characteristics of the LTME group were similar to those of the OTME group. In comparison with the OTME group, the resection margin was more by 0.21cm(p<0.00001), the duration of surgery was 26.32min longer(p<0.0001), the blood loss was 96.93ml less(p<0.0001), the time of starting fluid intake and first to passing flatus were earlier by 1.74day(p<0.0001) and 1.44day(p<0.00001),the hospital stay was 2.75day(p<0.0001) earlier,the rates of wound infection and total morbidity were less(p<0.01) than the OTME group. There were no significant differences in the rate of saving anus,retention of urine,anastomotic leakage and intestinal obstruction and the number of removed lymph nodes. There weren't differences in the local recurrence,distant metastasis and mortality each study.Conclusion: The safety and efficacy of LTME is equal to OTME, and the postoperative recovery is earlier, the morbidity is less than the OTME. But more good quality randomized controlled trials comparing long-term outcome are needed.