Laparoscopic vs open complete mesocolic excision with central vascular ligation for colon cancer: A systematic review and meta-analysis

Table 3 Results of meta-analysis comparing laparoscopic with open complete mesocolic excision for colon cancer

Outcome or subgroups	No. of Studies	Participants	Statistical method (95%CI)	Effect estimate (95%CI)	P value	Heterogeneity P, I2 (%)
Survival and recurrences
Overall survival	6	1777	OR (M-H, random)	1.32 (0.83, 2.10)	0.24	0.002, 70
Three-year	4	1010	OR (M-H, random)	2.02 (1.31, 3.12)	0.001	0.24, 28
Five-year	3	767	OR (M-H, random)	0.77 (0.44, 1.37)	0.38	0.07, 63
Disease free survival	4	856	OR (M-H, random)	1.15 (0.70, 1.87)	0.58	0.09, 54
Three-year	3	686	OR (M-H, random)	1.45 (1.00, 2.10)	0.05	0.89, 0
Five-year	1	170	OR (M-H, random)	0.50 (0.24, 1.05)	0.07	NA
Local recurrences	5	1233	OR (M-H, fixed)	0.67 (0.38, 1.17)	0.16	0.60, 0
One-year	2	466	OR (M-H, fixed)	0.52 (0.20, 1.35)	0.18	0.30, 7
Five-year	3	767	OR (M-H, fixed)	0.77 (0.38, 1.54)	0.46	0.52, 0
Distant recurrences	4	1018	OR (M-H, random)	0.98 (0.61, 1.58)	0.94	0.17, 40
Three-year	1	251	OR (M-H, random)	1.28 (0.54, 3.03)	0.58	NA
Five-year	3	767	OR (M-H, random)	0.90 (0.48, 1.69)	0.75	0.10, 57
Port site metastasis	2	494	OR (M-H, fixed)	1.52 (0.20, 11.42)	0.69	0.55, 0
Quality of the resected specimen
Lymphnodes retrieved	10	2647	MD (IV, random)	-1.06 (-3.65, 1.53)	0.42	< 0.001, 92
RCTs	1	1057	MD (IV, random)	1.00 (-0.34, 2.34)	0.14	NA
NRCTs	9	1590	MD (IV, random)	-1.32 (-4.42, 1.78)	0.40	< 0.001, 92
Lymphnodes retrieved	10	2647	MD (IV, random)	-1.06 (-3.65, 1.53)	0.42	< 0.001, 92
< 100 patients	4	478	MD (IV, random)	-3.18 (-8.69, 2.33)	0.26	< 0.001, 85
> 100 patients	6	2169	MD (IV, random)	0.29 (-1.64, 2.21)	0.77	< 0.001, 83
Lymphnodes retrieved	10	2647	MD (IV, random)	-1.06 (-3.65, 1.53)	0.42	< 0.001, 92
Europe	4	559	MD (IV, random)	-3.33 (-8.31, 1.64)	0.19	< 0.001, 90
Asia	6	2088	MD (IV, random)	0.56 (-1.33, 2.46)	0.56	< 0.001, 77
Tumor to arterial high tie (mm)	2	252	MD (IV, random)	14.26 (-4.30, 32.82)	0.13	< 0.001, 92
Resected mesocolon surface (cm2)	2	252	MD (IV, fixed)	11.75 (9.50, 13.99)	< 0.001	0.55, 0
Complete mesocolic plane excision	1	90	OR (M-H, fixed)	0.77 (0.20, 2.96)	0.71	NA
Operative data
Duration of surgery	7	2266	MD (IV, random)	26.26 (5.06, 47.46)	0.02	< 0.001, 94
Incision length (cm)	2	1159	MD (IV, random)	-14.01 (-14.35, -13.66)	< 0.001	0.89, 0
Blood loss (mL)	5	1868	MD (IV, random)	-52.11 (-78.57, -25.65)	< 0.001	< 0.001, 89
Transfusion requirement	2	1272	OR (M-H, random)	0.45 (0.27, 0.75)	0.002	0.54, 0
Intraoperative morbidity	1	1057	OR (M-H, fixed)	2.12 (0.95, 4.72)	0.07	NA
Postoperative course
Time to first flatus (d)	4	1771	MD (IV, random)	-0.90 (-1.46, -0.34)	0.002	< 0.001, 97
Time to liquid diet (d)	5	1031	MD (IV, random)	-1.84 (-2.93, -0.74)	0.001	< 0.001, 98
Short-term morbidity and mortality
Thirty-day overall morbidity	7	2144	OR (M-H, fixed)	0.57 (0.46, 0.71)	< 0.001	0.76, 0
RCTs	1	1057	OR (M-H, fixed)	0.66 (0.49, 0.89)	0.006	NA
NRCTs	6	1087	OR (M-H, fixed)	0.49 (0.36, 0.68)	< 0.001	0.89, 0
Wound complications	8	2322	OR (M-H, fixed)	0.43 (0.30, 0.61)	< 0.001	0.80, 0
Postoperative bleeding	4	1662	OR (M-H, fixed)	1.20 (0.46, 3.12)	0.71	0.75, 0
Pneumonia	5	867	OR (M-H, random)	0.61 (0.20, 1.84)	0.38	0.21, 32
Anastomotic leakage	8	2471	OR (M-H, fixed)	0.82 (0.54, 1.25)	0.36	0.77, 0
Need for reoperation	2	1113	OR (M-H, fixed)	0.59 (0.28, 1.23)	0.16	0.79, 0
Thirty-day mortality	6	2237	OR (M-H, fixed)	0.42 (0.16, 1.12)	0.07	0.98, 0
Hospital stay (d)	9	2573	MD (IV, random)	-4.07 (-5.87, -2.28)	< 0.001	< 0.001, 91

M-H: Mantel-haenszel analysis method; IV: Inverse variance analysis method; RCT: Randomized control trial; NRCs: Non-randomized control trials; MD: Mean difference; OR: Odds ratio; NA: Not applicable.