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Have early postoperative complications from laparoscopic rectal cancer surgery improved over the past 20 years?
Author(s) -
Shearer R.,
Gale M.,
Aly O. E.,
Aly E. H.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12302
Subject(s) - medicine , colorectal cancer , laparoscopy , laparoscopic surgery , surgery , randomized controlled trial , anastomosis , colorectal surgery , mortality rate , medline , general surgery , cancer , abdominal surgery , political science , law
Aim Laparoscopic rectal cancer surgery has been increasingly used since 1991 following the publication of the first case series. Since then, several studies have confirmed that laparoscopic surgery for rectal cancer is challenging with associated morbidity and mortality. The aim of this study was to determine if the rates of early postoperative complications in laparoscopic rectal cancer surgery have improved over the past 20 years. Method A literature search of the EMBASE and MEDLINE databases between A ugust 1991 and A ugust 2011 was conducted using the keywords laparoscopy, rectal cancer and postoperative complications. Data were analysed using linear regression ANOVA performed in gnumerics software. Results Ninety‐seven studies were included for analysis. Over the last 20 years there has been no significant change in the rate of any early postoperative complications (anastomotic leak, conversion, sexual, urinary or faecal dysfunction, wound infection, overall morbidity or mortality). However, in the last 3 years, the rate of positive resection margins has decreased significantly ( P = 0.01). Conclusion There was no evidence of a statistically significant change in early postoperative complications until 3 years ago. This may reflect the inherent morbidity associated with rectal surgery regardless of the approach used, the limitations of the current laparoscopic instrumentation or the relatively long learning curve. With increasing experience, a repeat analysis in the near future following the publication of ongoing randomized clinical trials might show improved outcomes.