Laparoscopic Versus Open Surgery for Mid-Low Rectal Cancer: a Systematic Review and Meta-Analysis on Short- and...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• The safety and long-term outcomes of laparoscopic surgery for mid-low rectal cancer remain debated.
• Assessing the feasibility of laparoscopic techniques is crucial for treatment advancements.

Purpose of the Study:

• To evaluate the safety and feasibility of laparoscopic surgery compared to open surgery for mid-low rectal cancer.
• To analyze both short-term and long-term outcomes of these surgical approaches.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, EMBASE, OVID, Web of Science, Cochrane Library).
• Meta-analysis of 13 studies (n=3,678) comparing laparoscopic and open rectal cancer surgery (tumor <10 cm from anal verge).
• Pooled analyses of dichotomous (odds ratios) and continuous (weighted mean differences) outcomes, including subgroup and sensitivity analyses.

Main Results:

• Laparoscopic surgery showed significantly less blood loss, fewer transfusions, and shorter recovery times (bowel function, diet, hospital stay).
• Lower rates of overall complications and wound infections were observed with the laparoscopic approach.
• Key pathological and oncological outcomes (lymph node harvest, margins, recurrence, survival) were similar between laparoscopic and open surgery groups.

Conclusions:

• Laparoscopic surgery is a safe and feasible option for mid-low rectal cancer treatment.
• It offers superior short-term benefits and reduced complications compared to open surgery.
• Pathological and long-term oncological outcomes are equivalent to traditional open surgery.