Short- and long-term outcomes of laparoscopic versus open surgery for rectal cancer A systematic review and meta-analysis of randomized controlled trials

Objectives: The present meta-analysis aimed to evaluate the short-and long-term outcomes of laparoscopic surgery (LS) versus open surgery (OS) for rectal cancer. Methods: PubMed, Web of Science, and Cochrane Library, were searched for eligible randomized controlled trials (RCTs) published up to June 2017. Operation related index, postoperative complication, and long-term survival rate and disease-free survival rate were evaluated by meta-analytical techniques. Result: Nine RCTs enrolling 4126 patients were included in the present meta-analysis. Compared to OS, LS had similar positive circumferential resection margin (CRM) and number of lymph nodes extracted (LNE) as well as long term 5 years survival rate and disease-free survival rate, but of which the risk tendency was higher in LS group. The short-term outcomes of major and total postoperative complication were lower in LS group. Conclusions: LS for rectal cancer was as safe and effective as OS in terms of long-term outcomes, but with lower postoperative complication.