Comparing the Outcomes of Laparoscopic Versus Open Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis

比较腹腔镜手术与开腹手术治疗结直肠癌的疗效:系统评价和荟萃分析

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Abstract

Colorectal cancer (CC) is a leading source of cancer-related morbidity and mortality globally. Laparoscopic surgery (LP), a minimally invasive approach, has gained popularity as a substitute for open surgery (OP) due to its potential benefits in recovery. This systematic review and meta-analysis sought to assess the relative outcomes of LP as opposed to OP for CC. The main interest was in the short-term outcomes (STO) of recovery, including blood loss, hospital stay, and postoperative complication. A systematic search of various databases (Cochrane Library, PubMed, Web of Science, Google Scholar) was performed to include cohort studies and randomized controlled trials (RCTs) from 2010 to 2025. Pooled analysis was done using a random-effects model, and heterogeneity was determined using the I² statistic. Publication bias was tested with funnel plots and Egger's test. The meta-analysis displayed that LP had significantly reduced hospital stays, less intraoperative blood loss, and fewer postoperative complications than OP. The pooled effect size for short-term recovery outcomes showed a moderate significant positive effect of LP on recovery (effect size = 0.56, 95% CI: -1.16 to 2.92). However, significant heterogeneity was observed (I² = 95.76%). These results suggest that LP offers substantial short-term recovery benefits, but heterogeneity indicates the need for further studies with longer follow-up and more diverse patient populations to confirm these findings and assess variations in outcomes.

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