Outcomes following open versus laparoscopic multi-visceral resection for locally advanced colorectal cancer : a systematic review and meta-analysis
Zaman, Shafquat Bhattacharya, Pratik Mohamedahmed, Ali Yasen Y Cheung, Fang Yi Rakhimova, Kamila Di Saverio, Salomone Peravali, Rajeev Akingboye, Akinfemi
Zaman, Shafquat
Bhattacharya, Pratik
Mohamedahmed, Ali Yasen Y
Cheung, Fang Yi
Rakhimova, Kamila
Di Saverio, Salomone
Peravali, Rajeev
Akingboye, Akinfemi
Abstract
Background: This meta-analysis aims to compare morbidity, mortality, oncological safety, and survival outcomes after laparoscopic multi-visceral resection (MVR) of the locally advanced primary colorectal cancer (CRC) compared with open surgery. Materials and methods: A systematic search of multiple electronic data sources was conducted, and all studies comparing laparoscopic and open surgery in patients with locally advanced CRC undergoing MVR were selected. The primary endpoints were peri-operative morbidity and mortality. Secondary endpoints were R0 and R1 resection, local and distant disease recurrence, disease-free survival (DFS), and overall survival (OS) rates. RevMan 5.3 was used for data analysis. Results: Ten comparative observational studies reporting a total of 936 patients undergoing laparoscopic MVR (n = 452) and open surgery (n = 484) were identified. Primary outcome analysis demonstrated a significantly longer operative time in laparoscopic surgery compared with open operations (P = 0.008). However, intra-operative blood loss (P<0.00001) and wound infection (P = 0.05) favoured laparoscopy. Anastomotic leak rate (P = 0.91), intra-abdominal abscess formation (P = 0.40), and mortality rates (P = 0.87) were comparable between the two groups. Moreover the total number of harvested lymph nodes, R0/R1 resections, local/distant disease recurrence, DFS, and OS rates were also comparable between the groups. Conclusion: Although inherent limitations exist with observational studies, the available evidence demonstrates that laparoscopic MVR in locally advanced CRC seems to be a feasible and oncologically safe surgical option in carefully selected cohorts.
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Date
2023-02-22
Type
Article
Subject
Surgery, Oncology. Pathology.
Collections
Citation
Zaman S, Bhattacharya P, Mohamedahmed AYY, Cheung FY, Rakhimova K, Di Saverio S, Peravali R, Akingboye A. Outcomes following open versus laparoscopic multi-visceral resection for locally advanced colorectal cancer: A systematic review and meta-analysis. Langenbecks Arch Surg. 2023 Feb 22;408(1):98. doi: 10.1007/s00423-023-02835-2
Journal / Source Title
Langenbeck's Archives of Surgery
DOI
10.1007/s00423-023-02835-2
PMID
36811741
Publisher
Springer