Hand-assisted laparoscopic surgery versus open surgery for colorectal disease: a systematic review and meta-analysis |
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| Affiliation: | 1. Department of Gastrointestinal Surgery, Guizhou Provincial People''s Hospital, Guiyang, China;2. Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, China;3. Department of Stomatology, Guizhou Provincial People''s Hospital, Guiyang, China;1. Department of Surgery, Temple University Hospital, 3401 North Broad Street, Suite 450, Philadelphia, PA 19140, USA;3. Division of Surgical Critical Care and Trauma, Temple University Hospital, 3401 North Broad Street, Suite 450, Philadelphia, PA 19140, USA;2. Department of Pharmacy, Temple University Hospital, Philadelphia, PA, USA;1. Department of Surgery, Division of Surgery Education, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104, USA;2. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;3. Clinical Effectiveness and Quality Improvement, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;4. Jefferson Medical College, Philadelphia, PA, USA;5. Center for Healthcare Improvement and Patient Safety, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;1. Welsh Institute for Minimal Access Therapy, Cardiff CF14 4UJ, UK;2. University Hospital Llandough, Cardiff, UK;3. Cardiff University, School of Medicine, Cardiff, UK;4. University Hospital of Wales, Cardiff, UK;1. Department of Surgery, Jewish General Hospital, McGill University, Montreal, Québec, Canada;2. Department of Surgery, McGill University Health Center, Montreal, Québec, Canada;3. Lady Davis Institute for Medical Research, Montreal, Québec, Canada;1. Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama 359-8513, Japan;2. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan;3. Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan;4. Laboratory for Mathematics, National Defense Medical College, Tokorozawa, Japan;5. Laboratory for Statistical Analysis, Center for Genomic Medicine, RIKEN, Yokohama, Japan |
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| Abstract: | BackgroundLaparoscopic colorectal surgery remains one of the most challenging techniques to learn.MethodsThe authors collected studies that have compared hand-assisted laparoscopic surgery (HALS) and open surgery for the treatment of colorectal disease over the past 17 years. Data of interest for HALS and open surgery were subjected to meta-analysis.ResultsTwelve studies that included 1,362 patients were studied. In total, 2.66% of HALS procedures were converted to laparotomy. Compared with the open surgery group, blood loss, rate of wound infection, and ileus in the HALS group decreased, and incision length, recovery of gastrointestinal function, and hospitalization period were shorter. There were no significant differences in operating time, hospitalization costs, mortality, and complications, including urinary tract infection, pneumonia, and anastomotic leak, between the groups.ConclusionsHALS has the advantages of minimal invasion, lower blood loss, shorter incision length, and faster recovery, and it can shorten the length of hospitalization without an increase in costs. The drawbacks are that a small number of patients who undergo HALS may need to be converted to laparotomy, and the oncologic safety and long-term prognosis are not clear. |
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| Keywords: | Hand-assisted laparoscopic surgery Laparoscopy Open surgery Colorectal Colon Meta-analysis |
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