Laparoscopic versus open surgery for rectal cancer: individual patient data meta-analysis of the ALaCaRT and Z6051 randomized trials.

The combined data set included 935 patients (65.6% men, mean age 60.7 years, mean body mass index 26.7 kg/m2) randomized to open (457 patients) or laparoscopic (478 patients) proctectomy.

Pathologically successful resection was lower in the laparoscopic than open group (85.1% versus 89.9%, respectively; pooled estimate 4.6% difference; 95% confidence interval (c.i.) -8.6% to -0.5%).

Non-inferiority of laparoscopic surgery was not demonstrated because the lower one-sided 95% c.i.