Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Review

Volume 7, Number 8, August 2015, pages 594-601

Laparoscopic Versus Open Colorectal Resection Within Fast Track Programs: An Update Meta-Analysis Based on Randomized Controlled Trials

Figures

Figure 1.
Figure 1. Flow chart illustrating the study selection process.
Figure 2.
Figure 2. Risk of bias summary: review authors’ judgments about each risk of bias item for each included study.
Figure 3.
Figure 3. Forest plots of pooled estimates on postoperative hospital stay. CI: confidence interval; df: degrees of freedom; MH: Mantel-Haenszel (statistical method).
Figure 4.
Figure 4. Forest plots of pooled estimates on total hospital stay. CI: confidence interval; df: degrees of freedom; MH: Mantel-Haenszel (statistical method).
Figure 5.
Figure 5. Forest plots of pooled data on surgical complications. CI: confidence interval; df: degrees of freedom; MH: Mantel-Haenszel (statistical method).

Tables

Table 1. Study Characteristics for the Included Studies
 
TrailYearCancerNo. of patientsPatients (O/L)Mean age (O/L) (years)Resection typeFollow-up
O/L: open surgery group/laparoscopic surgery group; NR: not reported; RH: right hemicolectomy; SR: sigmoid resection; LH: left hemicolectomy; RH: right hemicolectomy; AR: anterior resection; APR: abdominoperineal resection.
Basse et al [10]2005Colon6030/3075/75.5RH; SR30 days
King et al [11]2006Colon and rectum6019/4170.4/72.3LH; RH; SR; AR; APR42 days
Vlug et al [18]2011Colon19393/10066/66LH; RH30 days
Wang et al [19]2012Colon8141/4057.2/55.7LH; RH; SR30 days
Veenhof et al [20]2012Colon3617/1965/65LH; RHNR
Xie et al [21]2012Colon and rectum8040/4061.3/60.4LH; RH; APR30 days
Kennedy et al [22]2014Colon and rectum204101/10370.1/69.3LH; RH; AR; APR; other rectum and colon surgery> 1 year

 

Table 2. Key Features of the FT Programs for the Included Studies
 
StudyAvoid bowel prepStandard laxativesCarbohydrate loadedFluid restrictionStandard anestheticEarly feedingEarly mobilizationOtherNo. of ERAS elements
Basse et al [10]++-+++++7
King et al [11]++-+++++12
Vlug et al [18]--+-++++15
Wang et al [19]+-++++++10
Veenhof et al [20]--+-++++15
Xie et al [21]+--+++++10
Kennedy et al [22]-+++++++18
Total43457777Total

 

Table 3. Comparisons of Outcomes Between Laparoscopic and Open Colorectal Resection Within FT Programs
 
OutcomeStudiesNumberEffect estimate (95% CI)HeterogeneityTest for overall effect
The P values of comparisons are given in the column labeled “Test for overall effect”.
Mortality5598RR = 2.26 (0.62 - 8.22)x2 = 0, I2 = 0%, P = 0.50P = 0.21
Overall complications7714RR = 1.31 (1.12 - 1.54)x2 = 6.00, I2 = 0%, P = 0.42P = 0.0007
Readmission rates6678RR = 1.33 (0.79 - 2.22)x2 = 6.24, I2 = 20%, P = 0.28P = 0.28