Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials
| Autor: | Esther Kuhry, Ulla Romild, Robin Gaupset, Jaap Bonjer, Wolfgang Schwenk |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Colorectal cancer medicine.medical_treatment Hernia Inguinal Cochrane Library medicine Humans Radiology Nuclear Medicine and imaging Hernia Survival rate Colectomy Randomized Controlled Trials as Topic business.industry General surgery Hazard ratio Cancer General Medicine medicine.disease Hernia Ventral Surgery Survival Rate Treatment Outcome Oncology Laparoscopy Neoplasm Recurrence Local business Colorectal Neoplasms Follow-Up Studies |
| Zdroj: | Cancer treatment reviews. 34(6) |
| ISSN: | 0305-7372 |
| Popis: | Summary Background The aim of this systematic review is to evaluate long-term outcome of laparoscopically assisted versus open surgery for non-metastasised colorectal cancer. Methods Cochrane library, EMBASE, Pub med and CancerLit were searched for published and unpublished randomised controlled trials. RevMan 4.2 was used for statistical analysis. Results Twelve trials (3346 patients) reported long-term outcome and were included in the current analyses. No significant differences were found between laparoscopic and open surgery in the occurrence of incisional hernias or the number of reoperations for adhesions ( p =0.32 and 0.30, respectively). Port-site metastases and wound recurrences were rare and no differences in occurrence after laparoscopic and open surgery were observed ( p =0.16). Cancer-related mortality at maximum follow-up was similar after laparoscopic and open surgery ( p =0.15 and 0.16 for colon and rectal cancer, respectively). No significant difference in tumour recurrence after laparoscopic and open surgery for colon cancer was observed (3 RCTs, hazard ratio for tumour recurrence in the laparoscopic group 0.86; 95% CI 0.70–1.08). In colon cancer patients, no significant differences in overall mortality were found (2 RCTs, hazard ratio for overall mortality after laparoscopic surgery 0.86; 95% CI 0.86–1.07). Conclusions Laparoscopic resection of carcinoma of the colon is associated with a long-term outcome that is similar to that after open colectomy. Laparoscopic surgery for cancer of the upper rectum is feasible, but more randomised trials need to be conducted to assess long-term outcome. |
| Databáze: | OpenAIRE |
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