Is the incidence of postoperative anastomotic leakage different between laparoscopic and open total mesorectal excision in patients with rectal cancer? A meta-analysis based on randomized controlled trials and controlled clinical trials.

Objective: The purpose of this meta-analysis was to assess whether the incidence of postoperative anastomotic leakage (PAL) was different between laparoscopic and open total mesorectal excision (TME) in patients with rectal cancer. Materials and Methods: The PubMed, Medline, Cochrane Library, Wanfang and China National Knowledge Infrastructure databases were searched for selecting the randomized controlled trials (RCTs) and controlled clinical trials (CCT) on the incidence of PAL between laparoscopic and open TME for rectal cancer. The incidence rate of PAL was extracted from each of the individual study and pooled by the STATA-11.0 statistical software. Results: Six RCTs and 19 CCTs were included in this meta-analysis. The pooled results indicated that no statistical difference of PAL rate was found between aparoscopic and open TME in patients with rectal cancer (odds ratio [OR] =0.81, 95% confidence interval [CI]: 0.61-1.07, [P > 0.05]); The sub-group analysis when pooling the RCTs and CCTs respectively also indicated that there was no statistical difference of PAL rate between the laparoscopic and open TME (OR = 0.70, 95% CI: 0.35-1.39, [P > 0.05] for RCTs and OR = 0.84, 95% CI: 0.61-1.14, [P > 0.05]). Conclusion: Based on present studies, laparoscopic TME does not increase the risk of PAL.