Meta-analysis Of Laparoscopic And Open Surgery For Liver Metastases From Colorectal Cancer

Objective: To compare the clinical efficacy of laparoscopic and conventional laparotomy for colorectal cancer with liver metastasis,and to provide more evidence for the extensive development of laparoscopic techniques for the treatment of colorectal cancer with liver metastasis.Methods: The foreign literature was retrieved by computer,mainly pubmed database,vocabulary: laparoscopic OR laparoscopy,colorectal carcinoma OR colorectal cancer,colorectal liver metastases AND open.The language is set to English,the time is limited to 5 years,and the search time is from December 2013 to December 2018.All statistical analyses were performed using Review Manager version 5.3.The bivariate variables were calculated by odds ratio(OR)and the continuous variables were calculated by mean difference(MD)and 95% confidence interval(CI).Results: Eleven retrospective studies were performed on 2247 patients with colorectal cancer with liver metastases.One randomized controlled trial included 883 patients undergoing laparoscopic liver resection and 1364 patients underwent open liver cancer with colorectal cancer.In terms of surgical outcomes,laparoscopic surgery was longer than open surgery(MD: 2.90;CI: [1.78,4.03];P<0.00001,I2=70%);laparoscopic versus open hepatectomy Lower(MD,-153.00,95% CI,[-233.75,-72.25];P <0.0002);shorter hospital stay(MD,-2.99,95% CI,-3.64~-2.14;P.<0.00001)The incidence of postoperative complications was low(OR,0.39;95% CI,[0.26-0.60];P = 0.0001,I2 = 0%).Postoperative mortality(OR,0.37;95% CI,[0.14-0.96];P = 0.04),postoperative recurrence rate(OR,0.88;95% CI,[0.59-1.30];P = 0.49),no disease Survival rates(OR,0.79;95% CI,[0.61-1.03];P = 0.08),overall survival(OR,1.20;95% CI,[0.85-1.70];P = 0.30)were not significantly different.Oncology results for the two procedures: R0 resection rate(OR,0.94;95% CI,[0.66-1.35];P = 0.75)did not differ significantly.Conclusion: For the treatment of colorectal cancer with liver metastasis,laparoscopic technique is as safe and effective as open surgery,so that similar surgical results can be obtained,and there are certain minimally invasive advantages: for example,the amount of intraoperative blood loss is significantly reduced.Postoperative recovery is relatively fast.Clinically,it is still necessary to standardize the operation of the operation,improve the proficiency of the surgeon,and create a more tacit team.