Short-and long-term efficacy of three surgical approaches for synchronous surgical resection of colorectal cancer and liver metastases:A network Meta-analysis
LI Quanlin
XI Bin
LUO Binyu
YUAN Chunyan
GUO Qing
YANG Xuanhua
Abstract：Objective To compare the short and long-term curative effects of total laparoscopy,laparoscopic-assisted surgery,and complete laparotomy in the simultaneous resection in the treatment of colorectal cancer with liver metastasis.Methods Clinical research published in Pubmed,Embase,Web of Science,Cochrane Library,CNKI,and Wanfang Database comparing total laparoscopy,laparoscopic-assisted surgery,and complete laparotomy in the simultaneous resection and treatment of colorectal cancer with liver metastasis.A software,RevMan 5.3,Stata13 and R4.3.3 was used for the Meta-analysis of the extracted data.Results 18 studies were included in the pooled analysis.There were 1 655 instances in total,543 in the group that underwent total laparoscopy,378 in the group that underwent laparoscopic procedure with assistance,and 734 in the group that underwent complete laparotomy.The pairwise comparisons showed that the pure laparoscope group had better intra-operative hemorrhagic volume(MD=-154.62,95％CI:-220.08 to-89.17),number of intra-operative blood transfusions(MD=-1.81,95％CI:-2.86 to-1.15),postoperative complications(MD=-1.65,95％CI:-2.20 to-1.24),and hospital stay(MD=-2.90,95％CI:-3.83 to-1.96)than the complete laparotomy group,except that the surgery was less rapid(MD=47.99,95％CI:28.57 to 67.42)(all P＜0.05).The difference in overall and tumor-free survival was not statistically significant.The pure laparoscopic group had a longer operative time than the laparoscopic-assisted group(MD=40.26,95％CI:17.35 to 63.16),and the overall postoperative survival rate was not as high as that of the laparoscopic-assisted group(HR=1.69 95％CI:1.03 to 2.78)(all P＜0.05).There was no significant difference between the two groups in intra-operative hemorrhagic volume,intra-operative blood transfusion number,postoperative complications,and postoperative hospital stay.Conclusions Laparoscopic assist may be the best surgical approach for simultaneous resection of colorectal cancer with liver metastases under current conditions.However,the pure laparoscopy technology should only be used cautiously in centers that meet certain requirements and for appropriate cases.
Keywords：Colorectal cancerLiver metastasisLaparoscopySimultaneous resectionMeta-analysisNetwork
Publication Date：2025-10-20
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：10( 462-471 )