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Laparoscopic versus Open Surgery in Lateral Lymph Node Dissection for Advanced Rectal Cancer: A Meta-Analysis
Manzhao Ouyang1,2,3, Tianyou Liao1, Yan Lu1,4
1Department of Gastrointestinal Surgery, Shunde Hospital, Southern Medical University, Shunde, Foshan, Guangdong Province 528300, China.
Gastroenterology Research and Practice
|April 9, 2019
Summary
Laparoscopic lateral lymph node dissection (LLND) for advanced rectal cancer shows similar oncological outcomes to open surgery. This minimally invasive approach offers benefits like reduced blood loss and shorter hospital stays, making it a safe and feasible option.
Area of Science:
- Oncology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Advanced rectal cancer treatment often involves lateral lymph node dissection (LLND).
- Comparing surgical techniques is crucial for optimizing patient outcomes.
- Laparoscopic surgery offers potential advantages over traditional open procedures.
Purpose of the Study:
- To compare the clinical efficacy of laparoscopic versus conventional open surgery for LLND in advanced rectal cancer.
- To evaluate oncological and perioperative outcomes between the two surgical approaches.
Main Methods:
- A comprehensive meta-analysis of randomized controlled trials and comparative studies was conducted.
- Searched databases included PubMed, Embase, Cochrane Library, CNKI, and Wanfang Data.
- Clinical and oncological outcomes were assessed using RevMan 5.3 software.
Main Results:
- Eight studies with 892 patients (394 laparoscopic, 498 open) were analyzed.
- Laparoscopic LLND demonstrated significantly less intraoperative blood loss and shorter postoperative hospital stays.
- The laparoscopic approach also showed a higher R0 resection rate, with similar complication rates and long-term survival compared to open surgery.
Conclusions:
- Laparoscopic LLND is comparable to open surgery in oncological outcomes and complication rates for advanced rectal cancer.
- It offers advantages of reduced blood loss, shorter hospital stay, and improved R0 resection rates.
- Laparoscopic LLND is a safe, feasible, and potentially standard procedure for this patient group.
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