Li P, Fang F, Cai JX, Tang D, Li QG, Wang DR. Fast-track rehabilitation vs conventional care in laparoscopic colorectal resection for colorectal malignancy: A meta-analysis. World J Gastroenterol 2013; 19(47): 9119-9126 [PMID: 24379639 DOI: 10.3748/wjg.v19.i47.9119]
Corresponding Author of This Article
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
Research Domain of This Article
Geriatrics & Gerontology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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
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.
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.
