Laparoscopic versus open surgery for rectal cancer: a meta-analysis of 3-year follow-up outcomes

PURPOSE: We wished to evaluate the effectiveness of laparoscopic and open surgery for patients with rectum cancer through a meta-analysis. METHODS: We searched PubMed, EMBASE, and Cochrane database until June 30, 2015, to identify eligible studies. Randomized controlled trials comparing laparoscopic with open surgery for rectum cancer were included. Meta-analysis was performed using the search strategy following the requirement of the Cochrane Library Handbook. Three-year overall survival (OS) and disease-free survival (DFS) were the main endpoints. RESULTS: Eight randomized controlled trials comprising 3145 patients matched the selection criteria. Meta-analysis showed no significant difference between laparoscopic and open surgery in 3-year overall survival (OS) and disease-free survival (DFS) (hazard ratio (HR)(3-year OS) = 0.83, 95 % CI [0.68–1.01]; P = 0.06; HR(3-year DFS) = 0.89, 95 % CI [0.75,1.05]; P = 0.16). No evidence of publication bias was observed. CONCLUSION: Our meta-analysis supported the notion that based on the 3-year DFS and OS, oncological outcomes are comparable after laparoscopic and open surgery for rectal cancer.