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

Research Paper

A Meta-Analysis of the Short- And Long-Term Results of Randomized Controlled Trials That Compared Laparoscopy-Assisted and Open Colectomy for Colon Cancer

Hiroshi Ohtani^1✉, Yutaka Tamamori¹, Yuichi Arimoto¹, Yukio Nishiguchi², Kiyoshi Maeda³, Kosei Hirakawa³

1. Department of Surgery, Osaka City Sumiyoshi Hospital
2. Department of Surgery, Osaka City General Hospital
3. Department of Surgical Oncology, Osaka City University Graduate School of Medicine

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: meta-analysis, laparoscopy-assisted colectomy, colon cancer