Aim: We aimed to compare the oncological outcomes of laparoscopy and open resection for patients with rectal cancer following neoadjuvant chemoradiotherapy (NCRT). Methods: We searched the publications that compared the efficacy of laparoscopic surgery and open thoracotomy in treatment outcomes of rectal cancer after NCRT. All trials analyzed the summary hazard ratios of the endpoints of interest, including survival and individual postoperative complications. Results: Totally, 10 trials met our inclusion criteria. The pooled analysis of 3-year disease-free survival (OR 1.39, 95% CI 0.93–2.06; p = 0.11) and 3-year overall survival (OR 1.01, 95% CI 0.70–1.45; p = 0.97) showed that laparoscopic surgery did not achieve beneficial effects compared with open thoracotomy. The pooled result of duration of surgery indicated that laparoscopic surgery was associated with a trend for longer surgery time (SMD 27.53, 95% CI 1.34–53.72; p = 0.04), shorter hospital stay (SMD –1.64, 95% CI –2.70 to –0.58; p = 0.002), more postoperative complications (OR 0.77, 95% CI 0.60–0.99; p = 0.04), and decreased blood loss (SMD –49.87, 95% CI –80.61 to –19.14; p = 0.001). However, the number of removed lymph nodes, positive circumferential resection margin, as well as complications after surgery showed significant differences between the 2 groups. Conclusions: We focused on current evidence and reviewed the studies indicating that similar oncological outcomes were associated with laparoscopic surgery following NCRT for patients with locally advanced lower rectal cancer in comparison with open surgery.
Oncol Res Treat

中文翻译：

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直肠癌术前放化疗后腹腔镜与开放手术的预后比较：荟萃分析

目的：我们旨在比较腹腔镜和开腹手术治疗新辅助放化疗 (NCRT) 后直肠癌患者的肿瘤学结果。方法：我们检索了比较腹腔镜手术和开胸手术对 NCRT 后直肠癌治疗结果的疗效的出版物。所有试验都分析了感兴趣终点的汇总风险比，包括生存率和个体术后并发症。结果：总共有 10 项试验符合我们的纳入标准。3 年无病生存率（OR 1.39，95% CI 0.93–2.06； p = 0.11）和 3 年总生存率（OR 1.01，95% CI 0.70–1.45； p= 0.97) 表明与开胸手术相比，腹腔镜手术没有取得有益效果。手术持续时间的汇总结果表明，腹腔镜手术与更长的手术时间（SMD 27.53，95% CI 1.34-53.72；p = 0.04）、更短的住院时间（SMD -1.64，95% CI -2.70 至–0.58；p = 0.002），更多的术后并发症（OR 0.77，95% CI 0.60–0.99；p = 0.04），以及减少失血（SMD –49.87，95% CI –80.61 至 –19.14；p = 0.001）。但在切除淋巴结数量、环周切缘阳性以及术后并发症方面，两组间存在显着差异。结论：我们关注当前的证据并回顾了研究表明，与开放手术相比，局部晚期下直肠癌患者在 NCRT 后进行腹腔镜手术与相似的肿瘤学结果相关。
肿瘤资源治疗