| ObjectiveTo compare the safety and early efficacy in laparoscopic and traditional laparotomy for anus-preserving radical resection in low rectal cancer.MethodPubmed、China National Knowledge Infrastructure(CNKI)、WanFang Data were used to retrieve literatures that published from January 2008 to January 2018 comparing the efficacy of laparoscopic and laparotomy in anus-preserving surgery for low rectal cancer.The literatures were selected according to the proposed criteria,and extract the required indicators.Relevant data were combined and analyzed with Review Manager 5.3 software.ResultThe "NOS scale" was used to evaluate the quality of the 13 articles included.The results showed that there were 12 literature scores ≥6 points,which belonged to medium and high quality literatures.Through analysis,it can be concluded that the age,male ratio and tumor location of the patients in the laparoscopic group and the laparotomy group are relatively balanced.The operation time in the laparotomy group was 16.86 minutes shorter than that in the laparoscopic group(P<0.00001),and the intraoperative blood loss was 115.16 ml more(P<0.00001).There was no significant difference in the number of lymph nodes dissected between laparoscopic group and laparotomy group(P=0.93).The positive rate of circumferential margin cancer in laparoscopic group was higher than that in laparotomy group(OR=2.67,P=0.04).The incidence of incision-related complications in laparoscopic group was smaller than that in laparotomy group,and the difference was supported by statistics(OR=0.20,P=0.0005).In the incidence of anastomotic leakage,intestinal obstruction and urinary complications after operation,it couldn’t to conclude that there were differences between the two groups(all P>0.05).Compared with the laparotomy group,the first time of anal exhaust in the laparoscopic group was earlier(P<0.00001)and the hospital stay was 2.78 days less(P<0.00001).There was no significant difference in local recurrence rate,distant metastasis rate and survival rate between the two groups(P>0.05).ConclusionLaparoscopic surgery in the anus-preserving surgery for low rectal cancer has less injury and faster recovery than laparotomy surgery.There was no significant difference between the two methods in the safety of tumors and the survival rate of patients. |
