The Short-term Clinical Efficacy Of Two-port Laparoscopic Versus Conventional Laparoscopic Anterior Resection For Rectal Cancer:A Meta-analysis

Objective:To systematically evaluate the short-term clinical efficacy of two-port laparoscopic anterior resection(TPLAR)and conventional laparoscopic anterior resection(CLAR)for rectal cancer,and to analyze the safety and feasibility of TPLAR.Methods:The database both at home and abroad including PubMed,Cochrane Library,Wanfang,CNKI were searched until January 2020.Compared TPLAR and CLAR for rectal cancer in both Chinese and English literature were included.The RevMan 5.3 software was used for meta-analysis.Results:A total of 9 studies involving 639 patients met the inclusion criteria,including 302 patients in group TPLAR and 337 patients in group CLAR.Compared with group CLAR,group TPLAR had a shorter abdominal incision length(MD=-1.78,95%CI=-2.89~-0.67,P=0.002),and a lower pain score on the first day after surgery(MD=-0.77,95%CI=-1.37~-0.17,P=0.01),less intraoperative blood loss(MD=-7.15,95%CI=-11.78~-2.52,P=0.002),and shorter first flatus time after surgery(MD=-0.19,95%CI=-0.27~-0.11,P<0.00001).There were no significant differences(P>0.05)in terms of operation time,postoperative hospital stay,incidence of postoperative complications,conversion to open surgery rate,number of lymph nodes dissected,and distal resection margin between the two groups.Conclusions:TPLAR is safe and feasible,and the short-term clinical efficacy is equivalent to CLAR.TPLAR has the advantages of shorter length of abdominal incision,less blood loss,less pain after surgery,and shorter first flatus time after surgery.