A meta-analysis comparing hand-assisted laparoscopic right hemicolectomy and open right hemicolectomy for right-sided colon cancer

Abstract

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.

Investigation of clinical and pathological findings due to anatomical localisation in patients with colorectal cancer

“…In the same study, the average age of patients with right colon tumour was 65.5, the average age of patients with left colon tumours was also calculated as 65.4 years. 21 In our study, the mean age of right colon was 58.87, the mean age of the left column was 60. Although there was no statistically significant difference when comparing the two groups by age, in the left colon the mean age of the patients was greater.…”

Audit of laparoscopic surgery for colon cancer in Morocco: A report of the results of a prospective multicentre cohort study

“…The main difference was in the quality of resection in favour of the open surgery group. Most of the previous comparative studies have shown similar quality resection between laparoscopic and open surgery [ [27] , [28] , [29] , [30] ]. This difference could not be explained by patients or disease characteristics, since in the LS group there were significantly more favourable features compared to the OS group.…”

Laparoscopic versus Open Transverse-Incision Approach for Right Hemicolectomy: A Systematic Review and Meta-Analysis

“…Most data were from observational studies and the authors concluded that postoperative outcomes were almost comparable between the two surgical techniques. Finally, another very recent meta-analysis [ 25 ] compared hand-assisted laparoscopic ( n = 238) and open ( n = 268) right hemicolectomy for colon cancer. Five of the seven studies included in the analysis were non-RCTs for a total of 506 patients.…”