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首页> 外文期刊>Journal of laparoendoscopic and advanced surgical techniques, Part A >Laparoscopic versus open total mesorectal excision for middle and low rectal cancer: A meta-analysis of results of randomized controlled trials
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Laparoscopic versus open total mesorectal excision for middle and low rectal cancer: A meta-analysis of results of randomized controlled trials

机译：腹腔镜与开放式全直肠系膜切除术治疗中，低位直肠癌：一项随机对照试验结果的荟萃分析

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Background: Laparoscopic total mesorectal excision (LTME) for rectal cancer remains controversial. The aim of this meta-analysis of randomized controlled trials (RCTs) is to compare LTME and open total mesorectal excision (OTME) as the primary treatment for patients with middle and low rectal cancer with regard to short-term outcomes. Materials and Methods: Literature searches of electronic databases (PubMed, Embase, and the Cochrane Library) and manual searches up to October 30, 2011 were performed. Prospective randomized clinical trials were eligible if they included patients with middle and low rectal cancer treated by LTME versus OTME. Fixed and random effects models were used. Review Manager version 5.1 software was used for pooled estimates. Results: Four RCTs enrolling 624 participants (LTME group, 308 cases; OTME group, 316 cases) were included in the meta-analysis. LTME for rectal cancer was associated with a significantly longer operative time but significantly less intraoperative blood loss and earlier time to pass first flatus. We found no significant differences in the number of lymph nodes, overall morbidity, and perioperative mortality rates between the two groups. Time to resume liquid diet, time to resume normal diet, and length of hospital stay, although not significantly different between the two groups, did suggest a positive trend toward LTME. Conclusions: It may be concluded that LTME is a safe and effective alternative to OTME and is justifiable under the setting of clinical trials. Additional RCTs that compare LTME and OTME and investigate the long-term oncological outcomes of LTME are required to determine the advantages of LTME over OTME.
机译：背景：腹腔镜直肠系膜全直肠切除术（LTME）仍存在争议。这项针对随机对照试验（RCT）的荟萃分析的目的是比较LTME和开放全直肠系膜切除术（OTME）作为中，低位直肠癌患者短期治疗的主要治疗方法。资料和方法：进行了对电子数据库（PubMed，Embase和Cochrane图书馆）的文献检索以及截至2011年10月30日的手动检索。如果前瞻性随机临床试验包括LTME与OTME治疗的中低位直肠癌患者，则符合条件。使用固定和随机效应模型。使用Review Manager 5.1版软件进行汇总估算。结果：荟萃分析包括4个RCT，共624名参与者（LTME组308例; OTME组316例）。直肠癌的LTME与手术时间明显延长有关，但术中出血量明显减少，而首次出现肠胃气胀的时间较早。我们发现两组之间的淋巴结数目，总发病率和围手术期死亡率没有显着差异。恢复流质饮食的时间，恢复正常饮食的时间和住院时间，尽管两组之间没有显着差异，但这确实表明了LTME的积极趋势。结论：可以得出结论，LTME是OTME的安全有效替代品，在临床试验的背景下是合理的。为了确定LTME优于OTME的优势，还需要用于比较LTME和OTME并研究LTME长期肿瘤学结果的其他RCT。

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