Incidence of postoperative anastomotic leakage of laparoscopic versus open total mesorectal excision for rectal cancer:A meta-analysis
AIM: To explore whether the application of laparos-copy to total mesorectal excision increase the incidence of postoperative anastomotic leakage. METHODS: Literatures of randomized controlled trials ( RCT),controlled clinical trials and case series in Chinese and English relative to the incidence of postoperative anastomotic leakage of laparoscopic total mesorectal excision (LTME) versus open total mesorectal excision(OTME) for rectal cancer were searched for. Literatures were evaluated and data were screened by two authors independently and RevMan5.0.2.0 software was used for meta-analysis. RESULTS: Three individual RCT,2 individual case-control studies and 13 case-series were included. Considering the methodological heterogeneity of the included trials,we classified the samples by the methodologies employed in the trials. As no statistical heterogeneity of the methodologies used was seen in the subgroups,fixed effect model was used to analyze the overall effect. There was no statistical difference in the incidence of postoperative anastomotic leakage between the two groups (P = 0. 60) and the pooled odds ralio( OR) was 0.90(95% confidence interval,95% CI,0. 60 to 1.34). CONCLUSION: The application of laparoscopy to TME will not increase the incidence of postoperative anastomotic leakage. But the results of our study have some limitations due to nonrandom-ized controlled trials with grade 3 b and 4 included in the study and the relatively small-sized RCT samples. More RCTs with a large sample size are needed to further confirm the results.
rectal neoplasmslaparoscopic total mesorectal excisionopen total mesorectal excisionanastomotic leakageMeta-analysis
NETL
NSTL
万方数据
维普
