Meta-Analysis
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World J Gastroenterol. Dec 21, 2013; 19(47): 9119-9126
Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.9119
Fast-track rehabilitation vs conventional care in laparoscopic colorectal resection for colorectal malignancy: A meta-analysis
Ping Li, Fang Fang, Jia-Xun Cai, Dong Tang, Qing-Guo Li, Dao-Rong Wang
Ping Li, Fang Fang, Jia-Xun Cai, Dong Tang, Qing-Guo Li, Dao-Rong Wang, Department of Gastrointestinal Surgery, Subei People’s Hospital of Jiangsu Province, the First Affiliated Hospital of Yang Zhou University, Yangzhou 225001, Jiangsu Province, China
Qing-Guo Li, Department of Colorectal Surgery, Cancer Hospital Fudan University, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200433, China
Author contributions: Li P, Fang F and Li QG contributed equally to this study; Li P conceived and designed the review, conducted the statistical analyses and contacted authors of included studies to obtain additional information, and drafted the manuscript; Li QG and Wang DR provided supervision; Li P, Cai JX, Fang F and Tang D identified and acquired reports of trials, analyzed the data and assessed the risk of bias; All the authors contributed to the interpretation of the data, critically revised the manuscript, and approved the final version of the manuscript submitted for publication and are guarantors for the study.
Supported by The National Natural Science Foundation of China, No. 81201885 and No. 81172279
Correspondence to: Dao-Rong Wang, MD, Department of Gastrointestinal Surgery, Subei People’s Hospital of Jiangsu Province, the First Affiliated Hospital of Yang Zhou University, 98 Nantong West Road, Yangzhou 225001, Jiangsu Province, China. 734909944@qq.com
Telephone: +86-514-87373282 Fax: +86-514-87373282
Received: June 2, 2013
Revised: August 10, 2013
Accepted: September 15, 2013
Published online: December 21, 2013
Processing time: 232 Days and 16.9 Hours
Abstract

AIM: To evaluate the fast-track rehabilitation protocol and laparoscopic surgery (LFT) vs conventional care strategies and laparoscopic surgery (LCC).

METHODS: Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE, the Cochrane Central Register of Controlled Trials and EMBASE. The complications and re-admission after approximately 1 mo were assessed.

RESULTS: Six recent randomized controlled trials (RCTs) were included in this meta-analysis, which related to 655 enrolled patients. These studies demonstrated that compared with LCC, LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo. LFT had a pooled RR of 0.60 (95%CI: 0.46-0.79, P < 0.001) compared with a pooled RR of 0.69 (95%CI: 0.34-1.40, P > 0.5) for LCC.

CONCLUSION: LFT for colorectal malignancy is safe and efficacious. Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.

Keywords: Laparoscopic surgery; Fast-track rehabilitation; Enhanced recovery; Colorectal surgery; Complications; Readmission

Core tip: Fast-track rehabilitation in laparoscopic colorectal resection has become the most fashionable way to treat colorectal malignancy. Complications after fast-track rehabilitation protocol and laparoscopic surgery (LFT) and conventional care strategies and laparoscopic surgery (LCC) of colorectal resection have generally been discussed in China, as well as in other countries. This study clarified that compared with LCC, LFT has fewer complications and has a similar incidence of re-admission after approximately 1 mo.