Oncological outcomes of laparoscopic versus open rectal cancer resections: meta-analysis of randomized clinical trials

Abstract Background The role of laparoscopic rectal cancer surgery has been questioned owing to conflicting reports on pathological outcomes from recent RCTs. However, it is unclear whether these markers and the surgical approach have an impact oncological outcomes. This study assessed open resections. Methods A meta-analysis RCTs was performed. Primary endpoints included (disease-free survival (DFS), overall (OS), local recurrence). Secondary surrogate for quality resection. Results Twelve including 3744 patients (2133 laparoscopic, 1611 open) were included. There no significant difference in OS (hazard ratio (HR) 0.87, 95 per cent c.i. 0.73 1.04; P = 0.12; I2 0 cent) DFS (HR 0.95, 0.81 1.11; 0.52; between locoregional (odds (OR) 1.03, 0.72 1.48; 0.86; or distant (OR 0.70 1.08; 0.20; 7 recurrence groups. Achieving a successful composite score (intact mesorectal excision, clear circumferential resection margin distal margin) significantly associated with improved 0.55, 0.33 0.74; < 0.001; cent). An intact acceptable excision without superficial defects) had DFS. Finally, positive CRM worse Conclusion Well performed (laparoscopic achieves excellent very little two modalities. advantage benefit minimally invasive should be individual basis.