Hand-assisted Laparoscopic Versus Open Surgery Radical Resection Of Colorectal Cancer:a Meta Analysis

Objective:To compare outcomes of hand-assisted laparoscopic and open surgery radical resection of colorectal cancer using Meta analysis.Methods:Retrieved clinical trials about hand-assisted laparoscopic versus open surgery for the treatment of colorectal cancer all over the world were searched by Pubmed, Ovid、 ScienceDirect、CBM、 EMBASE,CNKI,VIP,WANFANG date published from2000to2013,and search their references. According inclusion/exclusion criteria, the use of double parallel excerpt methods were carried out by two researchers, and cross-checking, when disagreements were resolved by discussion or by a third party to decide. For lack of information through the contact author to complement, the data is the literature basic information, including the number of patients, characteristics, intervention, outcome indicators and so on. Then use Rev-Man5.0software to complete the statistical analysis including operation time, intraoperative blood loss, bowel function recovery time, the number of lymph nodes, post-operative stay in hospital, postoperative complications and report the result of the analysis.Results:According to the same screening criteria,8clinical trials were included in this analysis. These studies included a total of812patients:407treated with hand-assisted laparoscopic and405treated with open surgery. The baseline characteristics of two groups were similar.The Meta statistical showed as follow: hand-assisted laparoscopic was more less in surgical blood loss (WMD=-81.70ml,95%CI:-129.61--33.80ml, P<0.0008),the difference was statistically significant; hand-assisted laparoscopic was earlier in bowel function recovery time(WMD=-1.49d,95%CI:-1.79-1.18d, P<0.00001), a statistically significant difference; hand-assisted laparoscopic was less in post-operative stay in hospital (WMD=-3.12d,95%CI:-3.49-2.75d, P<0.00001), a statistically significant difference; slightly lower in postoperative complications (OR=0.44,95%CI:0.24-0.82, P=0.009) than open surgery, a statistically significant difference.; In the operation time between hand-assisted laparoscopic and open surgery was no statistically significant (WMD=6.01min,95%CI:-3.86-15.88min, P=0.23);There was no statistical difference between the two techniques in the number of lymph nodes(WMD=-0.69,95%CI:-1.62-0.24, P=0.15).Conclusion:For the treatment of colorectal cancer, compare with open surgery, hand-assisted laparoscopic causing tiny injury, more less blood loss, having quick recovery and having the lower morbidity rate of postoperative complications, hand-assisted laparoscopic is a safe and effective treatment. Due to the inclusion of literature research publication bias may exist, certainly produce effect on some research results, so we need to collect more high-quality literature for both evaluation in the later work, and to provide a solid, reliable evidence for clinical work.