Medial Versus Lateral Approach in Laparoscopic Colorectal Resection: A Systematic Review and Meta‐analysis

Ding, Jie; Liao, Guoqing; X, Yu; Zhang, Zhongmin; Pan, Yang; Liu, Sheng; Zhang, Yi; Yan, Zhang

doi:10.1007/s00268-012-1888-2

Cited by 36 publications

(29 citation statements)

References 51 publications

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“…In all cancer cases, a medial to lateral approach with high vessel ligation was used [24]. In 11/13 female patients, the specimen was extracted though a colpotomy, while in the remaining two cases, a supra-pubic mini-laparotomy was used.…”

Section: Resultsmentioning

confidence: 99%

Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery

et al. 2014

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BackgroundRecently major developments in video imaging have been achieved: among these, the use of high definition and 3D imaging systems, and more recently indocyanine green (ICG) fluorescence imaging are emerging as major contributions to intraoperative decision making during surgical procedures. The aim of this study was to present our experience with different laparoscopic procedures using ICG fluorescence imaging. Patients and methods108 ICG-enhanced fluorescence-guided laparoscopic procedures were performed: 52 laparoscopic cholecystectomies, 38 colorectal resections, 8 living-donor nephrectomies, 1 laparoscopic kidney autotransplantation, 3 inguino-iliac/obturator lymph node dissections for melanoma, and 6 miscellanea procedures. Visualization of structures was provided by a high definition stereoscopic camera connected to a 30° 10 mm scope equipped with a specific lens and light source emitting both visible and near infra-red (NIR) light (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany). After injection of ICG, the system projected high-resolution NIR real-time images of blood flow in vessels and organs as well as highlighted biliary excretion .ResultsNo intraoperataive or injection-related adverse effects were reported, and the biliary/vascular anatomy was always clearly identified. The imaging system provided invaluable information to conduct a safe cholecystectomy and ensure adequate vascular supply for colectomy, nephrectomy, or find lymph nodes. There were no bile duct injuries or anastomotic leaks.ConclusionsIn our experience, the ICG fluorescence imaging system seems to be simple, safe, and useful. The technique may well become a standard in the near future in view of its different diagnostic and oncological capabilities. Larger studies and more specific evaluations are needed to confirm its role and to address its disadvantages.

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Section: Resultsmentioning

confidence: 99%

Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery

et al. 2014

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“…8,9 A meta-analysis by Ding et al, 2013 has analysed 5 cohort studies including 2 randomized control trials and 3 retrospective studies incorporating 881 patients. 10 They reported significantly shorter operative time. Right-sided resections took 136 (114-145) minutes in the medial-tolateral group compared to 156 (136-157) minutes in the lateral-to-medial.…”

Section: Discussionmentioning

confidence: 97%

Medial versus lateral approache in laparscopic right hemicolectomy

et al. 2019

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Background: Approach to right colon cancer is through open exploration but it has many complication, now laparoscopic right hemicolectomy is an advanced cancer surgery, laparoscopic right hemicolectomy can be done by medial or lateral or combined approach.Methods: This is prospective study carried out on 30 patients admitted to department of surgery in menufia university hospital from September 2016 to September 2018 and all cases have RT colon cancer; The patients are divided into three groups, 1- group A (n=10): underwent medial approach for laparscopic right hemicolectomy 2- group B (n=10): underwent lateral approach for laparscopic right hemicolectomy, 3- group C (n=10) : underwent combined laparscopic medial and lateral approach, Blood loss, operative time, operative and postoperative complication were assessed. The period of follow up is for 6 months.Results: Operative duration and blood loss were significantly lower in combined approach. Intra and post operative complications were low in combined and MA.Conclusions: Laparoscopic combined approach reduces the operative time and blood loss than MA and LA. Besides the oncologic advantages of an early vessel division and a "no-touch" dissection.

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“…Therefore, numerous studied explored different surgical approaches and tried to find a better one. Jie Ding et al shown that the medial approach is a preferable approach at present [21] .…”

Section: Discussionmentioning

confidence: 99%

The tunnel approach versus medial approach in laparoscopic radical right hemicolectomy for colon cancer: A retrospective cohort study

zhang¹,

Zhang²,

Ma³

et al. 2020

Preprint

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Background: Although Multiple studies showed that the median approach is nowadays the most widely accepted approach according to the “no-touch” principle and safety. However, this approach is a demanding procedure with a steep learning curve and has a high rate of conversion to laparotomy. This aim is to explore the feasibility and safety of tunnel approach in laparoscopic radical right hemicolectomy for colon cancer.Methods：From July 2016 to October 2018, a total of 106 consecutive patients with colon cancer who were subjected to the laparoscopic radical right hemicolectomy in the affiliated cancer hospital of zhengzhou university were enrolled. The patients underwent either tunnel approach (TA) (n=56) or traditional medial approach (MA) (n=50) according to the surgical maneuver performed. The patients' baseline demographics and perioperative results were compared between the two groups.Results: The baseline characteristics did not differ between groups. The blood loss was significantly less [20.0(5.0-40.0) vs. 100(50.0-150.0) , p < 0.001] and operation time was significantly shorter [128.4±16.7 vs. 145.6±20.3min, p < 0.001]in the TA group than those in MA group. Time to first flatus and postoperative hospital stay were similar [3.0(2.0-4.0) vs. 3.0(3-4.0)d，p=0.329; 10.4±2.6 vs. 10.7±3.0d，p=0.506] in both groups. The conversion to laparotomy and complication rates were similar between the groups(0 vs. 6.0%, p = 0.203; 14.3% vs. 18.0%, p =0.603,respectively). There was no treatment-related death in both groups.Conclusions: The tunnel approach in laparoscopic radical right hemicolectomy for colon cancer is a technically feasible and safe procedure as a preferable approach at present compared to those of medial approach, meanwhile this method is easier for beginners to master. Hence this tunnel approach right hemicolectomy is worth recommended.

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Medial Versus Lateral Approach in Laparoscopic Colorectal Resection: A Systematic Review and Meta‐analysis

Cited by 36 publications

References 51 publications

Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery

Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery

Medial versus lateral approache in laparscopic right hemicolectomy

The tunnel approach versus medial approach in laparoscopic radical right hemicolectomy for colon cancer: A retrospective cohort study

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