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J Cancer. 2012;3:49-57. doi: 10.7150/jca.3621. Epub 2012 Jan 13.

A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy-assisted and open colectomy for colon cancer.

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1
1. Department of Surgery, Osaka City Sumiyoshi Hospital.

Abstract

PURPOSE:

We conducted a meta-analysis to evaluate and compare the short- and long-term results of laparoscopy-assisted colectomy (LAC) and open colectomy (OC) for colon cancer.

METHODS:

We searched MEDLINE, EMBASE, Science Citation Index, and Cochrane Controlled Trial Register for relevant papers published between January 1990 and October 2011 by using the search terms "laparoscopy," "laparoscopy-assisted," "surgery," "colectomy," "colon cancer," and "randomized clinical trials (RCTs)". We analyzed the outcomes of each type of surgery over short- and long-term periods.

RESULTS:

We selected 12 papers reporting RCTs that compared LAC with OC for colon cancer. Our meta-analysis included 4614 patients with colon cancer; of these, 2444 had undergone LAC and 2170 had undergone OC. In the short-term period, we found that the rates of overall postoperative complications and ileus in LAC were lower than in OC groups. LAC was associated with a reduction in intraoperative blood loss, a shorter duration of time to resumption and hospital stay, and lower rates of overall complication and ileus over the short-term, but with similar long-term oncologic outcomes such as overall and cancer-related mortality, overall recurrence, local recurrence, distant metastasis, and wound-site recurrence, compared to OC.

CONCLUSIONS:

It is suggested that LAC may be preferred to OC for colon cancer.

KEYWORDS:

colon cancer; laparoscopy-assisted colectomy; meta-analysis

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