Jie Ding1, Yu Xia2, Guo-qing Liao3, Zhong-min Zhang4, Sheng Liu5, Yi Zhang5, Zhong-shu Yan5. 1. Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital, Guiyang, China; Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, China. 2. Department of Stomatology, Guizhou Provincial People's Hospital, Guiyang, China. 3. Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, China. Electronic address: guoqingliao@126.com. 4. Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital, Guiyang, China. Electronic address: zhangzhongmin@medmai.com.cn. 5. Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, China.
Abstract
BACKGROUND: Laparoscopic colorectal surgery remains one of the most challenging techniques to learn. METHODS: The 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. RESULTS: Twelve 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. CONCLUSIONS: HALS 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.
BACKGROUND: Laparoscopic colorectal surgery remains one of the most challenging techniques to learn. METHODS: The 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. RESULTS: Twelve 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. CONCLUSIONS: HALS 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.
Authors: Zhobin Moghadamyeghaneh; Joseph C Carmichael; Steven Mills; Alessio Pigazzi; Ninh T Nguyen; Michael J Stamos Journal: J Gastrointest Surg Date: 2015-08-25 Impact factor: 3.452
Authors: Brian F Gilmore; Zhifei Sun; Mohamed Adam; Jina Kim; Brian Ezekian; Cecilia Ong; John Migaly; Christopher R Mantyh Journal: J Gastrointest Surg Date: 2016-07-25 Impact factor: 3.452