Does conversion during laparoscopic rectal oncological surgery increases postoperative complications and anastomotic leakage rates? A meta-analysis.

Autor: Finochi M; Department of digestive surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen cedex, France., Menahem B; Department of digestive surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen cedex, France; ANTICIPE INSERM U 1086, Centre François Baclesse, Avenue du Général Harris, 14045 Caen cedex, France; Pôle de Formation et de recherche en santé, 2, rue des Rochambelles, 14032 Caen cedex, France. Electronic address: menahem-b@chu-caen.fr., Eid Y; Department of digestive surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen cedex, France., Lubrano J; Department of digestive surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen cedex, France; ANTICIPE INSERM U 1086, Centre François Baclesse, Avenue du Général Harris, 14045 Caen cedex, France; Pôle de Formation et de recherche en santé, 2, rue des Rochambelles, 14032 Caen cedex, France., Alves A; Department of digestive surgery, University Hospital of Caen, Avenue de la Côte de Nacre, 14033 Caen cedex, France; ANTICIPE INSERM U 1086, Centre François Baclesse, Avenue du Général Harris, 14045 Caen cedex, France; Pôle de Formation et de recherche en santé, 2, rue des Rochambelles, 14032 Caen cedex, France.
Jazyk: angličtina
Zdroj: Journal of visceral surgery [J Visc Surg] 2020 Aug; Vol. 157 (4), pp. 277-287. Date of Electronic Publication: 2019 Dec 20.
DOI: 10.1016/j.jviscsurg.2019.12.004
Abstrakt: Objective: To evaluate, regarding previous published studies, postoperative outcomes between patients undergoing rectal cancer resection performed by totally laparoscopic approach (LAP) compared to those who underwent peroperative conversion (CONV).
Methods: Studies comparing LAP versus CONV for rectal cancer published until December 2017 were selected and submitted to a systematic review and meta-analysis. Articles were searched in Medline and Cochrane Trials Register Database. Meta-analysis was performed with Review Manager 5.0.
Results: Twelve prospective and retrospective studies with a total of 4503 patients who underwent fully laparoscopic approach for rectal cancer and a total of 612 patients who underwent conversion were included. Meta-analysis did not show any significant difference on overall mortality between both approaches (OR=0.47, 95%CI=0.18-1.22, P=0.12). However, Meta-analysis showed that anastomotic leakage rate, wound abscess rate and postoperative morbidity rate were significantly decreased with totally laparoscopic approach (OR=0.37, 95%CI =0.24-0.58, P<0.0001; OR=0.29, 95%CI=0.19-0.45, P<0.00001; OR=0.56, 95%CI=0.46-0.67, P<0.00001 respectively).
Conclusion: This meta-analysis suggests that conversion increases anastomotic leakage, overall morbidity and wound abscess rates without increasing mortality rate for patients who underwent rectal resection for cancer.
(Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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