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Yang S, Lin Y, Zhong W, Xu W, Huang Z, Cai S, Chen W, Zhang B. Effect of laparoscopic versus open surgery on postoperative wound complications in patients with low rectal cancer: A meta-analysis. Int Wound J 2024; 21:e14471. [PMID: 37935425 PMCID: PMC10898391 DOI: 10.1111/iwj.14471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/09/2023] Open
Abstract
This meta-analysis was conducted to evaluate the effect of microinvasive and open operations on postoperative wound complications in low rectal carcinoma patients. Research on limited English has been conducted systematically in PubMed, Embase, Cochrane Library and Web of Science. The date up to the search was in August 2023. Following review of the classification and exclusion criteria for this research and the evaluation of its quality in the literature, there were a total of 266 related papers, which were reviewed for inclusion in the period from 2004 to 2017. A total of 1774 cases of low rectal cancer were enrolled. Of these 913 cases, the laparoscopic operation was performed on 913 cases, while 861 cases were operated on low rectal carcinoma. The overall sample was between 10 and 482. Five trials described the efficacy of laparoscopy have lower risk than open on postoperative wound infection in patients with low rectal cancer (OR, 0.72;95 % CI, 0.48,1.09 p = 0.12). Three studies results showed that the anastomotic leak was not significantly different between open and laparoscopy (OR, 0.86; 95% CI, 0.58,1.26 p = 0.44). Six surgical trials in low rectal cancer patients reported haemorrhage, and five cases of surgical time were reported, with laparoscopy having fewer bleeding compared with open surgery (MD, -188.89; 95% CI, -341.27, -36.51 p = 0.02). Compared with laparoscopy, the operation time was shorter for the open operation (MD, 33.06; 95% CI, 30.56, 35.57 p < 0.0001). Overall, there is no significant difference between laparoscopy and open surgery in terms of incidence of infection and anastomosis leak. However, the rate of haemorrhage in laparoscopy is lower,and operation time in open surgery is lower.
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Affiliation(s)
- Shu Yang
- Department of Traditional Chinese MedicineThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Yuting Lin
- Department of Traditional Chinese MedicineThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Wenjin Zhong
- Department of Clinical LaboratoryThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Wenji Xu
- Department of gastroenterologyThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Zhongxin Huang
- Department of PathologyThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Suqin Cai
- Department of PathologyThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Wen Chen
- Department of Traditional Chinese MedicineThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
| | - Baogen Zhang
- Department of Traditional Chinese MedicineThe second affiliated hospital of Fujian Medical UniversityQuanzhouChina
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Zhang X, Wu Q, Hu T, Gu C, Bi L, Wang Z. Laparoscopic versus conventional open surgery in T4 rectal cancer: A case-control study. J Minim Access Surg 2019; 15:37-41. [PMID: 30416145 PMCID: PMC6293675 DOI: 10.4103/jmas.jmas_67_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Laparoscopic surgery (LAS) for T4 rectal cancer (RC) is still controversial. This study aims to compare LAS with conventional open surgery in patients with T4 RC. Patients and Methods: Patients undergoing laparoscopic or open curative resection for T4 RC from January 2010 to September 2014 in our hospital were enrolled. Patients’ clinicopathological characteristics and survival outcomes were collected and compared. All statistical analysis was performed using SPSS 22.0. Results: A total of 125 patients (39 open, 86 LAS) were included in this study finally. The baseline information between the two groups were comparable except that LAS group had a more anterior resection (P = 0.012) and less combined resection (P = 0.003). The results demonstrated that patients in LAS group had less blood loss (P < 0.001), smaller incision length (P < 0.001), faster time to first soft diet (P = 0.010) and less incidence of post-operative complications, although it was not significantly different (P = 0.063). In addition, the operative time was also comparable (P = 0.140) and the conversion rate was low (2/86). The 3-year overall survival (OS) was 71.8%, 79.1% in open, LAS group respectively and the 3-year disease-free survival (DFS) was 66.7%, 68.6% in open, laparoscopic group, respectively. The Kaplan curves demonstrated that there was no significant difference between the two groups in OS (P = 0.981) or DFS (P = 0.900). Conclusions: LAS is safe and feasible in selected patients with T4 RC. It can achieve a better perioperative outcomes, and the long-time survival is not inferior to open surgery. Prospective studies should be conducted in the future to reduce the selection bias.
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Affiliation(s)
- Xubing Zhang
- Department of Gastrointestinal Surgery, West China Hospital; West China School of Medicine, Sichuan University, Chengdu, China
| | - Qingbin Wu
- Department of Gastrointestinal Surgery, West China Hospital; West China School of Medicine, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Gastrointestinal Surgery, West China Hospital; West China School of Medicine, Sichuan University, Chengdu, China
| | - Chaoyang Gu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Bi
- Department of Gastrointestinal Surgery, West China Hospital; West China School of Medicine, Sichuan University, Chengdu, China
| | - Ziqiang Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
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Zhang X, Wu Q, Hu T, Gu C, Bi L, Wang Z. Laparoscopic Versus Conventional Open Abdominoperineal Resection for Rectal Cancer: An Updated Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A 2018; 28:526-539. [PMID: 29406806 DOI: 10.1089/lap.2017.0593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xubing Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Qingbin Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Chaoyang Gu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Bi
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Ziqiang Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
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Zhu K, Zhao Q, Yue J, Shi P, Yan H, Xu X, Wang R. GOLPH3 overexpression correlates with poor response to neoadjuvant therapy and prognosis in locally advanced rectal cancer. Oncotarget 2018; 7:68328-68338. [PMID: 27634904 PMCID: PMC5356558 DOI: 10.18632/oncotarget.12008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/07/2016] [Indexed: 12/16/2022] Open
Abstract
Neoadjuvant chemoradiotherapy (nCRT) combined with surgery is a standard therapy for locally advanced rectal cancer (LARC). The aim of this study was to assess the expression of GOLPH3 (Golgi phosphoprotein 3), a newly found oncogene, in LARC as well as its relationship with nCRT sensitivity and prognosis. We retrospectively analyzed 148 LARC cases receiving nCRT and total mesorectal excision (TME). Immunohistochemistry was used to assess GOLPH3 and mTOR (mammalian target of rapamycin) in tumor tissues. Then, the associations of GOLPH3 with pathological characteristics and prognosis of rectal cancer were assessed. The 148 cases included 77 with high GOLPH3 expression (52.03%), which was associated with tumor invasive depth and lymphatic metastasis. Cases with high GOLPH3 expression had 2.58 and 2.71 fold higher local relapse and distant metastasis rates compared with the low expression group. Correlation analyses showed that GOLPH3 was an independent indicator for judging tumor down-staging and postoperative TRG (tumor regression grade), indicating it could predict nCRT sensitivity. In addition, GOLPH3 expression was associated with mTOR levels. Multiple-factor analysis indicated that GOLPH3 was an independent prognosis indicator for 5 year-DFS (disease free survival) and OS (overall survival) in LARC. These results reveal that GOLPH3 is an independent predictive factor for nCRT sensitivity and prognosis in LARC, with a mechanism related to mTOR.
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Affiliation(s)
- Kunli Zhu
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China
| | - Qianqian Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China.,School of Medicine and Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China
| | - Jinbo Yue
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China
| | - Pengyue Shi
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China
| | - Hongjiang Yan
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China
| | - Xiaoqing Xu
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China
| | - Renben Wang
- Department of Radiation Oncology, Shandong Cancer Hospital, Affiliated to Shandong University, Jinan, China
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Zhang X, Wu Q, Hu T, Gu C, Bi L, Wang Z. Laparoscopic Versus Conventional Open Surgery in Intersphincteric Resection for Low Rectal Cancer: A Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A 2018; 28:189-200. [PMID: 29232537 DOI: 10.1089/lap.2017.0495] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xubing Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Qingbin Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Chaoyang Gu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Liang Bi
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Ziqiang Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
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Lefevre J, Benoist S. Practice patterns for complex situations in the management of rectal cancer: A multidisciplinary inter-group national survey. J Visc Surg 2017; 154:147-157. [DOI: 10.1016/j.jviscsurg.2016.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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7
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Lefevre JH, Benoist S. Controversies in the management of rectal cancer. A survey of French surgeons, oncologists and radiotherapists. Colorectal Dis 2016; 18:128-34. [PMID: 26679469 DOI: 10.1111/codi.13240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 12/11/2015] [Indexed: 02/08/2023]
Affiliation(s)
- J H Lefevre
- Department of General and Digestive Surgery, Hôpital Saint Antoine (AP-HP), Paris VI University, Paris, France
| | - S Benoist
- Department of General and Digestive Surgery, Hôpital Kremlin-Bicetre (AP-HP), Paris XI University, Paris, France
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Oki E, Ando K, Kasagi Y, Zaitsu Y, Sugiyama M, Nakashima Y, Sonoda H, Ohgaki K, Saeki H, Maehara Y. Recent advances in multidisciplinary approach for rectal cancer. Int J Clin Oncol 2015; 20:641-9. [PMID: 26100273 DOI: 10.1007/s10147-015-0858-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/03/2015] [Indexed: 01/16/2023]
Abstract
Surgery is a major treatment option for rectal cancer, and total mesorectal excision has been demonstrated to be advantageous in terms of oncological outcome and thus has been the standard surgical approach. Radiotherapy before or after radical surgery is the optimal treatment to control local recurrence of advanced rectal cancer. To date, in many countries, the combination of neoadjuvant concurrent chemotherapy and radiotherapy is considered the standard therapy. A more recent interest in neoadjuvant therapy has been the use of oxaliplatin or targeted agents for neoadjuvant chemoradiotherapy. However, despite many trials of oxaliplatin and targeted agents, 5-FU-based concurrent chemoradiotherapy has remained the only standard treatment option. Postoperative adjuvant chemotherapy with neoadjuvant chemoradiotherapy or induction chemotherapy with neoadjuvant chemoradiotherapy may further improve patient survival, as some clinical studies recently indicated. In Japan, neoadjuvant therapy is not the standard treatment method, because surgery with lateral lymph node dissection is usually performed and this type of surgery may reduce recurrence rate as does radiation therapy. The phase III study to evaluate the oncological effect of the Japanese standard operation (mesorectal excision, ME) with lateral lymph node dissection in comparison with ME alone for clinical stage II and III lower rectal cancer is currently ongoing.
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Affiliation(s)
- Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,
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