A meta-analysis of laparoscopy compared with open colorectal resection for colorectal cancer

The aim of this study was to compare the outcome of the overall complication, mortality, and recurrence rate between laparoscopic resection and open surgery for colorectal cancer. We searched the Medline, Embase, and Cochrane Library and systematically reviewed the randomized controlled trials by comparing the overall complication, mortality, and recurrence rate between laparoscopic resection and open surgery for colorectal cancer. Fifteen trials with 4,207 patients who reported long-term outcomes of the overall complication, mortality, and recurrence rate were included. The combined results of the individual trials showed no statistically significant difference in the odds ratio (OR) for overall recurrence (OR 0.92, 95% CI, 0.77-1.11, P=0.34), local recurrence (OR 0.81, 95% CI, 0.59-1.12, P=0.20), distant metastasis (OR 1.01, 95% CI, 0.78-1.30, P=0.95), wound-site recurrence (OR 1.97, 95% CI, 0.77-5.02, P=0.16), colorectal cancer-related mortality (OR 0.82, 95% CI, 0.66-1.02, P=0.07), colon cancer-related mortality (OR 0.85, 95% CI, 0.66-1.09, P=0.20), rectal cancer-related mortality (OR 0.76, 95% CI, 0.53-1.11, P=0.16), and overall mortality (OR 0.87, 95% CI, 0.73-1.73, P=0.11) between the laparoscopic surgery and open surgery groups. The overall complications in the laparoscopic surgery group were much lower than that in the open surgery group (OR 0.71, 95% CI, 0.58-0.87, P=0.001). This meta-analysis showed that the successful laparoscopic colorectal resection for colorectal cancer was as effective as open surgery in terms of the oncological outcomes, thereby suggesting that laparoscopic surgery can be continued in patients with colorectal cancer.