Background Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This systematic review and meta‐analysis aimed to compare intraoperative, postoperative, and oncological outcomes after LCME and open total mesocolon excision (OCME) for right‐sided colonic cancers. Methods Literature searches of electronic databases and manual searches up to January 31, 2019, were performed. Random‐effects meta‐analysis model was used. Review Manager Version 5.3 was used for pooled estimates. Results After screening 1334 articles, 10 articles with a total of 2778 patients were eligible for inclusion. Compared to OCME, LCME improves results in terms of overall morbidity (OR = 1.48, 95% CI 1.21 to 1.80, p = 0.0001), blood loss (MD = 56.56, 95% CI 19.05 to 94.06, p = 0.003), hospital stay (MD = 2.18 day, 95% CI 0.54 to 3.83, p = 0.009), and local (OR = 2.12, 95% CI 1.09 to 4.12, p = 0.03) and distant recurrence (OR = 1.63, 95% CI 1.23–2.16, p = 0.0008). There was no significant difference regarding mortality, anastomosis leakage, number of harvested lymph nodes, and 3‐year disease‐free survival. Open approach was significantly better than laparoscopy in terms of operative time (MD = − 34.76 min, 95% CI − 46.01 to − 23.50, p < 0.00001) and chyle leakage (OR = 0.41, 95% CI 0.18 to 0.96, p = 0.04). Conclusions This meta‐analysis suggests that LCME in right colon cancer surgery is superior to OCME in terms of overall morbidity, blood loss, hospital stay, and local and distant recurrence with a moderate grade of recommendation due to the retrospective nature of the included studies.

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Background Mini-invasive colorectal cancer surgery was adopted widely in recent years. This meta-analysis aimed to compare hand-assisted laparoscopic surgery (HALS) with open right hemicolectomy (OS) for malignant disease. Methods PRISMA guidelines with random effects model were adopted using Review Manager Version 5.3 for pooled estimates. Results Seven studies that involved 506 patients were included. Compared to OS, HALS improved results in terms of blood loss (MD = 53.67, 95% CI 10.67 to 96.67, p = 0.01), time to first flatus (MD = 21.11, 95% CI 14.99 to 27.23, p < 0.00001), postoperative pain score, and overall hospital stay (MD = 3.47, 95% CI 2.12 to 4.82, p < 0.00001). There was no difference as concerns post-operative mortality, morbidity (OR = 1.55, 95% CI 0.89 to 2.7, p = 0.12), wound infection (OR = 1.69, 95% CI 0.60 to 4.76, p = 0.32), operative time (MD = − 16.10, 95% CI [− 36.57 to 4.36], p = 0.12), harvested lymph nodes (MD = 0.59, 95% CI − 0.18 to 1.36, p = 0.13), and recurrence (OR = 0.97, 95% CI 0.30 to 3.15, p = 0.96). Conclusions HALS is an efficient alternative to OS in right colectomy which combines the advantages of OS with the mini-invasive surgery.

Case presentation A 68-year-old woman presented with a right breast mass of 6month duration, which was gradually increasing in size. Physical examination revealed a 10-cm mass in the upper outer quadrant of the right breast. This mass was firm, oval, non-tender, and free from the skin and underlying tissue. A medio-lateral mammogram revealed a homogeneous, dense, well-circumscribed lesion in the right breast (Figure 1). An axial computed tomography scan of the thorax showed a hypodense, well-defined mass with a capsular wall of 7 cm containing endogenous daughter cysts (Figure 2). Intraoperatively, an encapsulated breast mass with no adhesions was found. A surgical excision was performed. Histopathological

Background: The most frequent complication of liver hydatid cyst is intrabiliary rupture (LHCIBR). This study aimed to investigate preoperative predictive factors of occult and frank LHCIBR. Methods: We conducted a retrospective study concerning patients operated on consecutively for liver hydatidosis for 2 years. Patients were divided into three groups: who had no intrabiliary rupture, patients who had an occult rupture and patients who had a frank rupture. Results: We recorded 56 patients with 82 liver hydatid cysts. LHCIBR was occult in 16 cysts and frank in four cysts. Bivariate analysis identified jaundice and cyst size as associated with frank LHCIBR and US cyst type II or III, recurrent cyst, and size of the hydatid cyst as associated with occult LHCIBR. In the multivariate analysis, we retained jaundice, cyst size > 6.5 cm and duration of symptoms > 45 days as significant predictive factors of frank rupture and cyst size > 6.5 cm, number of recurrences ≥ 3, cyst type II or III, leukocytosis > 9.000/mm 3 and eosinophilia > 5.5% as significant of occult rupture. Conclusion: Misdiagnosis LHCIBR can lead to increased morbidity and mortality. They were avoided by predicting cyst rupture, correct timing and type surgery, proper drainage and preoperative intensive care of patients.