Systematic review of laparoscopic versus open surgery for colorectal cancer

Abstract

Background: This study compares the efficacy and safety of laparoscopic surgery (LS) and open surgery (OS) for colorectal cancer. Methods: An electronic search of the literature was undertaken to identify primary studies and systematic reviews. Information on the efficacy and safety of LS versus OS was analysed. A meta-analysis was conducted to examine long-term outcomes. Results: A systematic review published in 2000 and 12 more recent randomized clinical trials were identified. Compared with OS, LS reduced blood loss and pain, and resulted in a faster return of bowel function and earlier resumption of normal diet. Hospital stay was up to 2 days shorter after LS. No significant differences between the techniques were noted in the incidence of complications or postoperative mortality. The time required to complete LS was significantly longer (0-5-1-0 h more). No significant differences were found between the two procedures in terms of overall mortality, cancer-related mortality or disease recurrence. Conclusion: LS takes longer than OS but offers several short-term benefits. However, complication rates are similar for both procedures and no differences were found in long-term outcomes. Copyright © 2006 British Journal of Surgery Society Ltd.