The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis

The aim of the study was to compare short- and long-term outcomes of laparoscopic surgery and conventional open surgery for colorectal cancer. Published randomized controlled trial (RCT) reports of laparoscopic surgery and open surgery for colorectal cancer were searched, and short- and long-term factors were extracted to perform meta-analysis. A total of 15 RCT reports (6,557 colorectal cancer patients) were included in this study. Blood loss of laparoscopic surgery was less by 91.06 ml than open surgery (p = 0.044). Operation time was longer by 49.34 min (p = 0.000). The length of hospital stay was shorter by 2.64 days (p = 0.003). Incisional length was shorter by 9.23 cm (p = 0.000). Fluid intake was shorter by 0.70 day (p = 0.001). Bowel movement was earlier by 0.95 day (p = 0.000). Incidence of complications, blood transfusion, and 30 days death were significantly lower in laparoscopic surgery than in open surgery (p = 0.011, 0.000, 0.01). But there was no significant difference in lymph nodes (p = 0.535) and anastomotic leak (p = 0.924). There was also no significant difference in 3 and 5 years overall survival (p = 0.298, 0.966), disease-free survival (p = 0.487, 0.356), local recurrence (p = 0.270, 0.649), and no difference in 5 years distant recurrence (p = 0.838). Laparoscopic surgery is a mini-injured approach which can cure colorectal cancer safely and radically, and it is not different from conventional open surgery in long-term effectiveness, so laparoscopic surgery can be tried to widely use in colorectal cancer.