A meta-analysis and systematic review of perioperative outcomes of laparoscopic-assisted rectal resection (LARR) versus open rectal resection (ORR) for carcinoma
Article
Article Title | A meta-analysis and systematic review of perioperative outcomes of laparoscopic-assisted rectal resection (LARR) versus open rectal resection (ORR) for carcinoma |
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ERA Journal ID | 16878 |
Article Category | Article |
Authors | Memon, Muhammed A. (Author), Yunus, Rossita M. (Author), Memon, Breda (Author), Awais, Aiman (Author) and Khan, Shahjahan (Author) |
Journal Title | Surgical Laparoscopy, Endoscopy and Percutaneous Techniques |
Journal Citation | 28 (6), pp. 337-348 |
Number of Pages | 12 |
Year | 2018 |
Publisher | Lippincott Williams & Wilkins |
Place of Publication | United States |
ISSN | 1530-4515 |
1534-4908 | |
Digital Object Identifier (DOI) | https://doi.org/10.1097/SLE.0000000000000589 |
Web Address (URL) | https://journals.lww.com/surgical-laparoscopy/Abstract/2018/12000/A_Meta_Analysis_and_Systematic_Review_of.1.aspx |
Abstract | Aims and objectives: The aim was to conduct a systematic review and meta-analysis of the randomized evidence to determine the relative merits of perioperative outcomes of laparoscopic-assisted (LARR) versus open rectal resection (ORR) for proven rectal cancer. Materials and methods: A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English-language randomized clinical trials comparing LARR and ORR. The meta-analysis was prepared in accordance with the PRISMA statement. Thirteen outcome variables were analyzed. Random effects meta-analyses were performed due to heterogeneity. Results: A total of 14 randomized clinical trials that included 3843 rectal resections (LARR 2096, ORR 1747) were analyzed. The summary point estimates favored LARR for the intraoperative blood loss, commencement of oral intake, first bowel movement, and length of hospital stay. There was significantly longer duration of operating time of 38.29 minutes for the LARR group. Other outcome variables such as total complications, postoperative pain, postoperative ileus, abdominal abscesses, postoperative anastomotic leak, reintervention and postoperative mortality rates were found to have comparable outcomes for both cohorts. Conclusions: LARR was associated with significantly reduced blood loss, quicker resumption of oral intake, earlier return of gastrointestinal function, and shorter length of hospital stay at the expense of significantly longer operating time. Postoperative morbidity and mortality and analgesia requirement for both these groups were comparable. LARR seems to be a safe and effective alternative to ORR; however, it needs to be performed in established colorectal units with experienced laparoscopic surgeons. |
Keywords | rectal carcinoma, anterior resection, rectal resection,open surgery, laparoscopic surgery, randomized controlled trials |
ANZSRC Field of Research 2020 | 429999. Other health sciences not elsewhere classified |
490502. Biostatistics | |
Public Notes | Files associated with this item cannot be displayed due to copyright restrictions. |
Byline Affiliations | School of Agricultural, Computational and Environmental Sciences |
South East Queensland Surgery, Australia | |
Institution of Origin | University of Southern Queensland |
https://research.usq.edu.au/item/q1y1y/a-meta-analysis-and-systematic-review-of-perioperative-outcomes-of-laparoscopic-assisted-rectal-resection-larr-versus-open-rectal-resection-orr-for-carcinoma
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