Laparoscopic versus open resection for rectal cancer: a meta-analysis of randomized clinical trials S. Trastulli, R. Cirocchi, C. Listorti, D. Cavaliere, N. Avenia, N. Gullà, G. Giustozzi, F. Sciannameo, G. Noya, C. Borselli. Colorectal Disease on line first 13 FEB 2012 Aim: Laparoscopic and open rectal resection for cancer were compared analyzing a total of 26 end points which included intraoperative and postoperative recovery, short-term morbidity and mortality, late morbidity and long term oncologic outcome. Methods: We searched for published randomized clinical trials, presenting a comparison between laparoscopic and open rectal resection for cancer by using the following electronic databases: Pub Med, OVID Medline, Cochrane database of systematic reviews, EBM reviews, CINAHL and EMBASE.Results: Nine randomized clinical trials (RCT) were included in the meta-analysis incorporating 1,544 patients with 841 having laparoscopic 703 open rectal resection for cancer. Laparoscopic surgery for rectal cancer was associated with a statistically significant reduction in intraoperative blood loss and in the number of blood transfusions, earlier return of bowel function and a shorter duration of hospital stay. We also found a significant advantage for laparoscopy in the reduction of wound infection, post-operative intra abdominal bleeding, late intestinal adhesion obstruction and in the late morbidity. No differences were found in terms of intra-operative and late oncologic outcomes.Conclusion: The metanalysis indicates that laparoscopy benefits patients, with shorter hospital stay, earlier return of bowel function, reduced blood loss, number of blood transfusion and lower rates of wound infection, intra-abdominal postoperative bleeding, late intestinal adhesion obstruction and other late morbidity.