Objective To evaluate short-term effect of laparoscopic and open Miles operations for lower rectal carcinoma. Methods A total of 119 patients with lower rectal carcinoma were retrospectively collected from March 2012 to March 2017 in this hospital, among which 65 were in the laparoscopic operation group and 54 in the open operation group. The perioperative data, pathological results, recovery courses, and complications were compared between the two groups. Results Compared with the open operation group, the laparoscopic group showed a longer operation time (t=6.035, P=0.002), quicker bowel function recovery (t=4.919, P<0.001), faster off-bed activity (t=2.221, P<0.001), and shorter hospital stay time (t=3.795, P=0.025). The intraoperative blood loss (t=0.154, P=0.698) and the number of harvested lymph nodes (t=0.532, P=0.595) were similar between the two groups. The laparoscopic operation group showed a significant lower total complication rate (χ2=7.174, P=0.009) as compared with the open operation group, but the incision infection, urinary tract injury, lung infection, thrombosis of lower extremities, etc. had no significant differences between the two groups (P>0.050). Conclusion Laparoscopic Miles operation improves postoperative recovery and reduces postoperative complications as compared with open approach in treatment of lower rectal cancer, with similar oncological and short-term results.
ObjectiveThis meta-analysis aimed to systematically evaluate the feasibility and the safety of total laparoscopic pancreatoduodenectomy (TLPD) by comparing it with open pancreatoduodenectomy (OPD).MethodsWe searched the relative domestic and international data bases systematically, such as the Cochrane Library, Medline Database, SCI, CBM, VIP-data, CNKI-data, and WanFang Data. We selected case control studies or cohort studies, and used the Review Manager 5.3 to perform statistical analysis.ResultsIn total, thirteen single-center retrospective case-control studies were included, totally 808 patients involved, and there were 401 cases in the TLPD group and 407 cases in the OPD group. There were no significant difference in terms of the cumulative morbidity, incidence of the Clavien Ⅲ-Ⅴ complication, pancreatic fistula, B/C pancreatic fistula, biliary fistula, postoperative hemorrhage, pulmonary infection, and gastric emptying delay, as well as the ratio of secondary operation, mortality of perioperative period, the ration of R0 resection, and the number of lymph nodes dissected between the 2 groups (P>0.05). Although the operative time was significant longer, TLPD had significant superiority in terms of the amount of bleeding and blood transfusion during operation, the hospital stays after operation, the bowel function recovery time, the time to restart eating, and the time to reactivate (P<0.05).ConclusionIn terms of the relative complications and the parameters of oncology such as the ration of R0 resection, the number of lymph nodes dissected, both of the procedures are safe and feasible, while TLPD is more favorable to control operative bleeding and accelerate rehabilitation.