Table 2.
Results of the meta-analyses comparing laparoscopic rectal resection vs open rectal resection
|
Outcome variables |
Number of studies (Number of patients) |
RR or MD |
95%CI
(Low; High) |
P value |
Heterogeneity, I2
(P value) |
Sensitivity analysis by including the largest multi-centric RCTs |
||||
| Number of studies (Number of patients) |
RR or MD |
95%CI (Low; High) |
P value | Heterogeneity, I2 (P value) | ||||||
| Intraoperative outcomes | ||||||||||
| Operative time | 12 (3723) | 36.67 | 27.22; 46.11 | <0.00001 | 89% (< 0.00001) | 4 (2319) | 41.18 | 24.88; 57.48 | < 0.00001 | 85% (0.0002) |
| Intraoperative morbidity | 4 (1909) | 0.97 | 0.74; 1.27 | 0.82 | 8% (0.35) | 2 (1500) | 1.02 | 0.60; 1.72 | 0.94 | 61% (0.11) |
| Estimated blood loss | 11 (3380) | -88.8 | -117.25; -60.34 | < 0.00001 | 83% (< 0.00001) | 4 (2319) | -82.1 | -158.87; -5.34 | 0.04 | 94% (< 0.00001) |
| Incision length | 5 (1629) | -11.17 | -13.88; -8.47 | < 0.00001 | 99% (< 0.00001) | 3 (1275) | -10.51 | -16.16; -4.85 | 0.0003 | 99% (< 0.00001) |
| Ureter injury | 5 (2256) | 1.23 | 0.20; 7.72 | 0.82 | 51% (0.11) | 2 (1500) | 2.59 | 0.66; 10.11 | 0.17 | 0% (0.67) |
| Gastrointestinal injury | 4 (2052) | 1.14 | 0.25; 5.17 | 0.86 | 73% (0.02) | 2 (1500) | 1.05 | 0.13; 8.22 | 0.96 | 86% (0.007) |
| Postoperative outcomes | ||||||||||
| Postoperative morbidity | 12 (3313) | 0.98 | 0.88; 1.09 | 0.75 | 16% (0.3) | 3 (1844) | 1.02 | 0.91; 1.15 | 0.69 | 0% (0.65) |
| Postoperative mortality | 13 (3751) | 0.65 | 0.34; 1.23 | 0.19 | 0% (1) | 4 (2319) | 0.60 | 0.27; 1.33 | 0.21 | 0% (0.89) |
| Length hospital stay | 12 (3738) | -1.71 | -2.84; -0.58 | 0.003 | 90% (< 0.00001) | 4 (2296) | -0.25 | -0.90; 0.39 | 0.44 | 52% (0.10) |
| Anastomotic leak | 9 (2253) | 0.97 | 0.69; 1.34 | 0.84 | 0% (0.6) | 3 (1351) | 1.19 | 0.79; 1.80 | 0.41 | 0% (0.53) |
| Reoperation rate | 7 (2468) | 0.93 | 0.64; 1.34 | 0.69 | 3% (0.4) | 3 (1844) | 1.19 | 0.77; 1.86 | 0.43 | 0% (0.42) |
| Ileus | 10 (2930) | 0.77 | 0.55; 1.06 | 0.11 | 0% (0.66) | 3 (1875) | 0.79 | 0.43; 1.44 | 0.44 | 62% (0.07) |
| Bowel recovery | 9 (3149) | -0.68 | -1.00; -0.36 | < 0.0001 | 79% (< 0.00001) | 3 (1922) | -0.59 | -1.24; 0.07 | 0.08 | 87% (0.0005) |
| Wound infection | 10 (2684) | 0.81 | 0.61; 1.09 | 0.16 | 0% (0.5) | 1 (1042) | 0.82 | 0.43;1.47 | 0.5 | NA |
| Chest infection | 7 (1252) | 1.55 | 0.82; 2.93 | 0.17 | 0% (0.61) | 0 (0) | - | - | - | - |
| Urinary infection | 7 (1075) | 0.89 | 0.50; 1.57 | 0.68 | 15% (0.32) | 0 (0) | - | - | - | - |
RR: Risk ratios; MD: Mean difference; CI: Confidence interval; NA: Not applicable.