Abstract:

Meta-analysis of the postoperative complication rate on laparoscopic surgery versus open surgery for transverse colon cancer        HE Jia-lun*，ZHANG Hong, LING Yun-zhi, et al. *Department of Colorectal Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, China
Corresponding author: ZHANG Hong, E-mail：haojiubujian1203@sina.cn
Abstract    Objective    To compare the postoperative complication rate of laparoscopic surgery and conventional open surgery for transverse colon cancer. Methods    The published studies of comparing efficacies between laparoscopic surgery and conventional open surgery from January 1，1991 to July 31，2017 were searched from Pubmed，Embase，Cochrane library，CNKI，Vip data and Wanfang data.The RevMan 5.3 software was used for data analysis. Results    A total of 18 studies including 1989 cases were analyzed. A total of 1007 patients received laparoscopic surgery. There were 982 cases undergoing conventional open surgery.The results of Meta analysis showed that the overall postoperative complication rate in laparoscopic group and conventional open surgery were 14.2% and 21.1%. The overall postoperative complication rate，incision complication rate and postoperative respiratory complication rate in laparoscopic group were lower than those in conventional open surgery（OR=0.64，0.46，0.38;95%CI 0.50—0.82，0.28—0.75，0.15—0.94;P＜0.05）. There was no statistically significant difference in the incidence of postoperative anastomotic fistula，hemorrhage，intestinal obstruction，chylous ascites and circulatory complications between the two groups（P＞0.05）. Conclusion  Laparoscopic surgery is superior to conventional open surgery in reducing postoperative complications for transverse colon cancer. Laparoscopic surgery can be safely and effectively applied to the treatment of transverse colon cancer.

Key words: transverse colon cancer, laparoscopy, postoperative complication, Meta analysis

摘要：

目的    比较腹腔镜与开放横结肠癌切除术后并发症发生率的差异。方法    计算机检索Pubmed、Embase、Cochrane Library数据库、中国期刊全文数据库（CNKI）、维普和万方数据库，收集1991年1月1日至2017年7月31日之间公开发表的腹腔镜与开放手术治疗横结肠癌的研究论文，应用Cochrane协作网提供的RevMan5.3软件进行Meta分析。结果    最终纳入研究18篇，累计样本量1989例，其中腹腔镜组1007例，开放组982例。Meta分析结果显示腹腔镜组术后总体并发症发生率为14.2%，开放组为21.1%，腹腔镜组明显少于开放组（OR=0.64，95%CI 0.50～0.82，P＜0.05）。亚组分析显示：腹腔镜组术后切口并发症发生率（OR=0.46，95%CI 0.28～0.75，P＜0.05）和呼吸系统并发症发生率（OR=0.38，95%CI 0.15～0.94，P＜0.05）低于开放组。两组术后吻合口漏、出血、肠梗阻、乳糜性腹腔积液、循环系统并发症的发生率差异无统计学意义（均P＞0.05）。结论    腹腔镜横结肠癌手术较传统开放手术在减少术后并发症方面具有优势，腹腔镜手术可以安全有效的应用于横结肠癌的治疗。

关键词: 横结肠癌, 腹腔镜, 术后并发症, Meta分析