Skip to main content
Erschienen in: International Journal of Colorectal Disease 7/2006

01.10.2006 | Original Article

Meta-analysis of short-term outcomes after laparoscopic resection for rectal cancer

verfasst von: Feng Gao, Yun-Fei Cao, Li-Sheng Chen

Erschienen in: International Journal of Colorectal Disease | Ausgabe 7/2006

Einloggen, um Zugang zu erhalten

Abstract

Background

Laparoscopic resection (LR) has become increasingly popular for the management of rectal cancer. Despite a decade of experience, the safety and efficacy of LR for rectal cancer remains to be established. This report performs a meta-analysis to compare LR with conventional open resection (CR) in patients with rectal cancer.

Methods

Using a defined search strategy, studies directly comparing CR with LR for rectal cancer were identified. The data for patients with rectal cancer treated with both approaches were extracted and used in our meta-analysis. Open surgery and laparoscopic surgery were compared in terms of postoperative mortality, morbidity, complications, oncological clearance, operating time, and time before recovery to a normal diet.

Results

Compared with CR, LR is associated with lower morbidity rates [OR 0.63 (0.41, 1.96) P=0.03], longer operating times [weighted mean difference 1.59 (1.20, 1.98) P<0.00001], similar mortality rates, wound healing disorder rates, urinary disorder rates, cardiopulmony disease rates, all leakage rates, all abscess rates and a positive rate of margin.

Conclusion

LR is associated with less postoperative morbidity, but longer operation time. A prospective randomized controlled trial is warranted to fully investigate these and other outcome measures.
Literatur
1.
Zurück zum Zitat Delgado S, Lacy AM, Filella X, Castells A, Garcia Valdecasas JC, Piqué JM, Momblán D, Visa J (2001) Acute phase response in laparoscopic and open colectomy in colon cancer: randomized study. Dis Colon Rectum 44:638–646PubMedCrossRef Delgado S, Lacy AM, Filella X, Castells A, Garcia Valdecasas JC, Piqué JM, Momblán D, Visa J (2001) Acute phase response in laparoscopic and open colectomy in colon cancer: randomized study. Dis Colon Rectum 44:638–646PubMedCrossRef
2.
Zurück zum Zitat Franklin MEJ, Rosenthal D, Abrego-Medina D, Dorman JP, Glass JL, Norem R, Diaz A (1996) Prospective comparison of open vs. laparoscopic colon surgery for carcinoma: five year results. Dis Colon Rectum 39:S35–S46PubMedCrossRef Franklin MEJ, Rosenthal D, Abrego-Medina D, Dorman JP, Glass JL, Norem R, Diaz A (1996) Prospective comparison of open vs. laparoscopic colon surgery for carcinoma: five year results. Dis Colon Rectum 39:S35–S46PubMedCrossRef
3.
Zurück zum Zitat Lacy AM, García Valdecasas JC, Delgado S, Castells A, Taurà P, Piqué JM, Visa J (2002) Randomized trial of laparoscopic-assisted colectomy versus open colectomy for the treatment of non-metastatic colon cancer. Lancet 359:2224–2229PubMedCrossRef Lacy AM, García Valdecasas JC, Delgado S, Castells A, Taurà P, Piqué JM, Visa J (2002) Randomized trial of laparoscopic-assisted colectomy versus open colectomy for the treatment of non-metastatic colon cancer. Lancet 359:2224–2229PubMedCrossRef
4.
Zurück zum Zitat Schiedeck T, Schwandner O, Baca I, Baehrlehner E, Konradt J, Kockerking F, Kuthe A et al (2000) Laparoscopic surgery for the cure of colorectal cancer: results of a German five-center study. Dis Colon Rectum 43:1–8PubMedCrossRef Schiedeck T, Schwandner O, Baca I, Baehrlehner E, Konradt J, Kockerking F, Kuthe A et al (2000) Laparoscopic surgery for the cure of colorectal cancer: results of a German five-center study. Dis Colon Rectum 43:1–8PubMedCrossRef
5.
Zurück zum Zitat Darzi A, Lewis C, Menzies-Gow N, Guillou PJ, Monson JR (1995) Laparoscopic abdominoperineal excision of the rectum. Surg Endosc 9:414–417PubMed Darzi A, Lewis C, Menzies-Gow N, Guillou PJ, Monson JR (1995) Laparoscopic abdominoperineal excision of the rectum. Surg Endosc 9:414–417PubMed
6.
Zurück zum Zitat Seow-Choen F, Eu KW, Ho YH, Leong AF (1995) A preliminary comparison of a consecutive series of open versus laparoscopic abdomino-perineal resection for rectal adenocarcinoma. Int J Colorectal Dis 12:88–90CrossRef Seow-Choen F, Eu KW, Ho YH, Leong AF (1995) A preliminary comparison of a consecutive series of open versus laparoscopic abdomino-perineal resection for rectal adenocarcinoma. Int J Colorectal Dis 12:88–90CrossRef
7.
Zurück zum Zitat Leung KL, Kwok SP, Lau WY, Meng WC, Chung CC, Lai PB, Kwong KH (2000) Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma. Surg Endosc 14:67–70PubMedCrossRef Leung KL, Kwok SP, Lau WY, Meng WC, Chung CC, Lai PB, Kwong KH (2000) Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma. Surg Endosc 14:67–70PubMedCrossRef
8.
Zurück zum Zitat Hartley JE, Mehigan BJ, Qureshi AE, Duthie GS, Lee PW, Monson JR (2001) Total mesorectal excision: assessment of the laparoscopic approach. Dis Colon Rectum 44:315–321PubMedCrossRef Hartley JE, Mehigan BJ, Qureshi AE, Duthie GS, Lee PW, Monson JR (2001) Total mesorectal excision: assessment of the laparoscopic approach. Dis Colon Rectum 44:315–321PubMedCrossRef
9.
Zurück zum Zitat Pasupathy S, Eu KW, Ho YH, Seow-Choen F (2001) A comparison between open versus laparoscopic assisted colonic pouches for rectal cancer. Tech Coloproctol 5:19–22PubMedCrossRef Pasupathy S, Eu KW, Ho YH, Seow-Choen F (2001) A comparison between open versus laparoscopic assisted colonic pouches for rectal cancer. Tech Coloproctol 5:19–22PubMedCrossRef
10.
Zurück zum Zitat Araujo SE, da Silva e Sousa AH Jr, de Campos FG, Habr-Gama A, Dumarco RB, Caravatto PP, Nahas SC, da Silva J, Kiss DR, Gama-Rodrigues JJ (2003) Conventional approach x laparoscopic abdominoperineal resection for rectal cancer treatment after neoadjuvant chemoradiation: results of a prospective randomized trial. Rev Hosp Clin Fac Med Sao Paulo 58:133–140PubMed Araujo SE, da Silva e Sousa AH Jr, de Campos FG, Habr-Gama A, Dumarco RB, Caravatto PP, Nahas SC, da Silva J, Kiss DR, Gama-Rodrigues JJ (2003) Conventional approach x laparoscopic abdominoperineal resection for rectal cancer treatment after neoadjuvant chemoradiation: results of a prospective randomized trial. Rev Hosp Clin Fac Med Sao Paulo 58:133–140PubMed
11.
Zurück zum Zitat Hu JK, Zhou ZG, Chen ZX, Wang LL, Yu YY, Liu J, Zhang B, Li L, Shu Y, Chen JP (2003) Comparative evaluation of immune response after laparoscopical and open total mesorectal excisions with anal sphincter preservation in patients with rectal cancer. World J Gastroenterol 9:2690–2694PubMed Hu JK, Zhou ZG, Chen ZX, Wang LL, Yu YY, Liu J, Zhang B, Li L, Shu Y, Chen JP (2003) Comparative evaluation of immune response after laparoscopical and open total mesorectal excisions with anal sphincter preservation in patients with rectal cancer. World J Gastroenterol 9:2690–2694PubMed
12.
Zurück zum Zitat Kwok S-Y, Chung CC-C, Tsang WW-C, Li MK-W (2004) Laparoscopic resection for rectal cancer in patients with previous abdominal surgery: a comparative study. Ann Coll Surg Hong Kong 8:115–119CrossRef Kwok S-Y, Chung CC-C, Tsang WW-C, Li MK-W (2004) Laparoscopic resection for rectal cancer in patients with previous abdominal surgery: a comparative study. Ann Coll Surg Hong Kong 8:115–119CrossRef
13.
Zurück zum Zitat Wu WX, Sun YM, Hua YB, Shen LZ (2004) Laparoscopic versus conventional open resection of rectal carcinoma: a clinical comparative study. World J Gastroenterol 10:1167–1170PubMed Wu WX, Sun YM, Hua YB, Shen LZ (2004) Laparoscopic versus conventional open resection of rectal carcinoma: a clinical comparative study. World J Gastroenterol 10:1167–1170PubMed
14.
Zurück zum Zitat Zhou ZG, Hu M, Li Y, Lei WZ, Yu YY, Cheng Z, Li L, Shu Y, Wang TC (2004) Laparoscopic versus open total mesorectal excision with anal sphincter preservation for low rectal cancer. Surg Endosc 18:1211–1215PubMedCrossRef Zhou ZG, Hu M, Li Y, Lei WZ, Yu YY, Cheng Z, Li L, Shu Y, Wang TC (2004) Laparoscopic versus open total mesorectal excision with anal sphincter preservation for low rectal cancer. Surg Endosc 18:1211–1215PubMedCrossRef
15.
Zurück zum Zitat Breukink SO, Pierie JP, Grond AJ, Hoff C, Wiggers T, Meijerink WJ (2005) Laparoscopic versus open total mesorectal excision: a case-control study. Int J Colorectal Dis 20:428–433PubMedCrossRef Breukink SO, Pierie JP, Grond AJ, Hoff C, Wiggers T, Meijerink WJ (2005) Laparoscopic versus open total mesorectal excision: a case-control study. Int J Colorectal Dis 20:428–433PubMedCrossRef
Metadaten
Titel
Meta-analysis of short-term outcomes after laparoscopic resection for rectal cancer
verfasst von
Feng Gao
Yun-Fei Cao
Li-Sheng Chen
Publikationsdatum
01.10.2006
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 7/2006
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-005-0079-0

Weitere Artikel der Ausgabe 7/2006

International Journal of Colorectal Disease 7/2006 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.