Table 3.
Meta-analysis of main endpoints.
| Endpoints | No. of patients | No. of trials (No. of RCTs) | NOSE | CL | HR/OR/WMD (95%CI) | P-value | I2 (%) | P-value for heterogeneity |
|---|---|---|---|---|---|---|---|---|
| ONCOLOGICAL OUTCOMES (REFERENCES) | ||||||||
| Five-year DFS (5, 25) | 496 | 2 (0) | 260 | 236 | 0.84 (0.54 to 1.31) | 0.45 | 0 | 0.83 |
| Lymph node harvest (4, 10, 11, 16, 26, 29, 30) | 727 | 7 (0) | 295 | 432 | −0.97 (−1.97 to 0.03) | 0.06 | 0 | 0.76 |
| Proximal margin, cm (26, 27, 29) | 350 | 3 (0) | 163 | 187 | 0.47 (−0.49 to 1.42) | 0.34 | 0 | 0.72 |
| Distal margin, cm (26, 27, 29) | 350 | 3 (0) | 163 | 187 | −0.11 (−0.66 to 0.45) | 0.70 | 24 | 0.27 |
| SAFETY OUTCOMES | ||||||||
| Surgical site infection (4, 5, 10, 12, 26, 29, 30) | 808 | 7 (1) | 369 | 439 | 0.15 (0.05 to 0.42) | <0.001 | 0 | 0.99 |
| Anastomotic leakage (5, 9, 11, 26, 27, 29) | 819 | 6 (0) | 383 | 436 | 0.71 (0.36 to 1.38) | 0.31 | 0 | 0.96 |
| Blood loss, ml (4, 5, 11, 16, 26, 27, 30) | 893 | 7 (0) | 378 | 515 | −12.23 (−29.35 to 4.90) | 0.16 | 89 | <0.001 |
| Intra-abdominal abscess (5, 16, 29) | 460 | 3 (0) | 230 | 230 | 1.34 (0.30 to 6.05) | 0.70 | 0 | 0.47 |
| Total perioperative complications (4, 5, 9–11, 16, 24–29) | 1,317 | 12 (1) | 609 | 708 | 0.56 (0.41 to 0.75) | <0.001 | 15 | 0.30 |
| OTHER OUTCOMES | ||||||||
| Operation time, min (4, 5, 9–12, 16, 26–30) | 1,175 | 12 (1) | 518 | 657 | 17.34 (6.14 to 28.54) | 0.002 | 81 | <0.001 |
| Hospital stay, day (4, 5, 9–12, 16, 26–30) | 1,175 | 12 (1) | 518 | 657 | −0.56 (−1.09 to −0.04) | 0.03 | 54 | 0.01 |
| Pain score (9, 11, 16, 29, 30) | 455 | 5 (0) | 190 | 265 | −1.42 (−1.94 to 0.90) | <0.001 | 85 | <0.001 |
| Time to first flatus, day (11, 16, 26, 27, 29) | 615 | 5 (0) | 262 | 353 | −0.57 (−0.70 to −0.44) | <0.001 | 0 | 0.48 |
NOSE, natural orifice specimen extraction; CL, conventional laparoscopic surgery; HR, hazard ratio; OR, odds ratio; WMD, weighted mean difference; 95%CI; 95% confidence interval; DFS, diseases-free survival.