Comparison between different approaches applied in laparoscopic right hemi-colectomy: A systematic review and network...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Laparoscopic right hemi-colectomy involves various surgical techniques.
• Evaluating the comparative benefits of these approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To conduct a network meta-analysis (NMA) comparing medial to lateral (MtL), lateral to medial (LtM), and cranial to caudal (CtC) approaches in laparoscopic right hemi-colectomy.
• To identify potential benefits and drawbacks of each surgical strategy.

Main Methods:

• A systematic literature search was conducted across multiple databases (PubMed, Embase, Medline, Cochrane, Wan Fang, CNKI).
• Included studies were original articles comparing two or three laparoscopic right colon resection approaches (MtL, LtM, CtC) for neoplastic and benign diseases.
• Data from 3 RCTs and 3 NRCTs involving 571 patients were synthesized.

Main Results:

• The LtM approach demonstrated significantly shorter postoperative flatus recovery time compared to both MtL and CtC approaches.
• Hospital stay was shorter with the LtM approach than with the MtL approach.
• The CtC approach showed a trend towards fewer postoperative complications compared to the MtL approach.

Conclusions:

• All three approaches (MtL, LtM, CtC) are generally safe and acceptable for laparoscopic right hemi-colectomy.
• The LtM approach offers advantages in terms of faster flatus recovery and reduced hospitalization duration compared to the MtL approach.
• The CtC approach may provide a slight benefit in reducing postoperative complications relative to the MtL approach.