A Meta-analysis Of The Outcomes And Postoperative Complications Of Laparoscopic And Open Surgery For Colonic Cancer

Objective: To compare the outcomes and postoperative complications of laparoscopic surgery and open surgery for colonic cancer,and evaluate the advantage of laparoscopic surgery for colonic cancer,so as to provide some reference for the surgeons.Methods: The randomized controlled trials between Jan.2005 and Jan.2015,reported on the outcomes and postoperative complications of laparoscopic versus open surgery for colonic cancer,were collected by searches of CNKI and VIP.To extract the feature information of articles.The criteria of literature enrollment and exclusion was made,strictly according to which the literatures were screened.Then evaluate the quality of literatures.Data were extracted from these literatures,and data analysis was performed by RevMan 4.7,including weighed mean difference(WMD),odds ratio(OR)and 95%confidence interval(95%CI).Funnel plot graphics indicate publication bias.Results: According to the selection criteria,A total of 2766 patients from 25 literatures was selected,including 1392 patients in the laparoscopic surgery group and 1374 patients in the open surgery group.Except body mass index,the age and gender were similar between the two groups.The results of this meta-analysis indicate that the operation time and number of lymph node dissection in both groups had no statisticaldifferences(P?0.05),while the intraoperative blood less,intestinal function recovery time,average time of off-bed and hospital stay were evidently lower and shorter than the patients in the open surgery group(P<0.05).Moreover,the incidences of intestinal obstruction,rebleeding after operation,intestinal fistula,lung infection and wound infection were lower than the open group(P<0.05).There was no statistically significant difference in the Long-term outcomes between the two groups(P>0.05),including recurrence rate in 5 years,survival rate in 3 years and 5 years.Conclusion: The long-term outcomes of laparoscopic surgery group are similar to that of open surgery group for colon cancer,however,the laparoscopic surgery group has obvious advantages in short-term outcomes.Simultaneously,it also can significantly reduce the incidence of postoperative complications,such as intestinal obstruction,intestinal fistula and lung infection.Therefore,laparoscopic surgery for colon cancer is an acceptable alternative.