Comparison of chyle leakage between laparoscopic and open colectomy in patients with colon cancer: a systematic review and meta-analysis
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Published on: March 24, 2023
Tharin Thampongsa1, Sitanun Saengsri1, Pichet Wattanapreechanoni1
1Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Purpose:
Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This meta-analysis aimed to compare the rate of chylous leakage between laparoscopic and open right colectomy with CME for right-sided colonic cancers.
Methods:
A literature search was performed up to February 2022. The primary outcome was the rate of chylous leakage. Secondary outcomes included related surgical and clinical parameters. A meta-analysis was performed to calculate risk ratios.
Results:
Eleven studies were included. The rate of postoperative chylous leakage was lower in laparoscopic surgery compared to open surgery (risk ratio, 0.63; 95% confidence interval, 0.33-1.20), although this difference was not statistically significant. LCME showed superior outcomes to open CME (OCME) in secondary outcomes, such as reduced blood loss, increased harvested lymph node count, and decreased overall morbidity.
Conclusions:
There was no significant difference between LCME and OCME regarding the rates of chylous leakage, anastomosis leakage, or operative time. However, LCME demonstrated superiority in blood loss reduction, harvested lymph node number, and overall morbidity in patients undergoing surgery for right colon cancer.
