Comparison of clinical outcomes between hand assisted laparoscopic and standard laparoscopic right hemicolectomy: a meta-analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Guosen ,  ZHOU Jianping , SHENG Weiwei , DONG Ming

Department of Gastrointestinal Surgery & Hernia and Abdominal Wall Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, P.R.China;

Corresponding author：

ZHOU Jianping, Email: zjphama@163.com

Keywords：

hand assisted laparoscopic; standard laparoscopic; right hemicolectomy; meta-analysis

DOI：

10.7507/1007-9424.201610050

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To assess clinical outcomes of hand assisted laparoscopic right hemicolectomy (HALC) and standard laparoscopic right hemicolectomy (SLC). Methods The databases of Wanfang, CNKI, VIP, CBM, PubMed, Embase, and Cochrane Central Register of Controlled Trials were electronically searched. The relevant literatures were selected according to the inclusion and exclusion criteria. The Cochrane collaboration tool for assessing risk of bias was used to assess the quality of randomized controlled trials and the Newcastle-Ottawa Scale was used to assess non-randomized comparative studies. Meta-analysis was performed by using RevMan 5.3 software. Results A total of 9 studies were included and involved 976 patients (480 patients in the HALC group and 496 patients in the SLC group). The results of meta-analysis showed that the HALC group was favor of shorter operative time as compared with the SLC group (P<0.05), but the length of incision and hospital stay were longer in the HALC group (P<0.05). There were no statistically significant differences between these two groups regarding as the conversion rate, time to return of bowel function, feeding time, reoperative rate during hospitalization, postoperative complications rate, and harvested lymph node number (P>0.05). As for the follow-up results, the 3-year survival rate was about 90%, and 5-year survival rate was about 80%, and there were no statistical differences in terms of recurrence rate and mortality between the HALC group and the SLC group (P>0.05). Conclusions Both HALC and SLC could achieve satisfactory minimal invasive outcomes and oncologic radical effects, and HALC has an advantage of shorter operative time, yet length of incision and hospital stay are longer than SLC. Therefore, HALC could be considered as an alternative to minimal invasive right hemicolectomy.

Citation： WANG Guosen, ZHOU Jianping, SHENG Weiwei, DONG Ming. Comparison of clinical outcomes between hand assisted laparoscopic and standard laparoscopic right hemicolectomy: a meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(5): 562-571. doi: 10.7507/1007-9424.201610050 Copy

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2.	Boland JP, Kusminsky RE, They EH. Laparoscopic mini-laparotomy with manipulation: The middle path. Minim Invasive Ther Allied Technol, 2009, 18(2): 63-67.
3.	Marcello PW, Fleshman JW, Milsom JW, et al. Hand-assisted laparoscopicvs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum, 2008, 51(6): 818-828.
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6.	Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005, 5: 13.
7.	Bae SU, Park JS, Choi YJ, et al. The role of hand-assisted laparoscopic surgery in a right hemicolectomy for right-sided colon cancer. Ann Coloproctol, 2014, 30(1): 11-17.
8.	Ng LW, Tung LM, Cheung HY, et al. Hand-assisted laparoscopicversus total laparoscopic right colectomy: a randomized controlled trial. Colorectal Dis, 2012, 14(9): e612-e617.
9.	Papaconstantinou HT, Sharp N, Thomas JS. Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg, 2011, 213(1): 72-80.
10.	Vogel JD, Lian L, Kalady MF, et al. Hand-assisted laparoscopic right colectomy: how does it compare to conventional laparoscopy? J Am Coll Surg, 2011, 212(3): 367-372.
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13.	李大伟. 手辅助腹腔镜与腹腔镜行右半结肠切除术临床效果比较. 中国现代医生, 2014, 52(13): 135-137.
14.	石刚, 董明, 宋纯, 等. 手助腹腔镜与全腹腔镜在右半结肠癌根治术中应用的前瞻性病例对照研究. 中国内镜杂志, 2015, 21(2): 113-116.
15.	邱辉忠, 徐徕, 牛备战, 等. 腹腔镜手助与辅助技术在右半结肠切除术中应用的对比研究. 中华胃肠外科杂志, 2011, 14(7): 545-548.
16.	Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc, 1991, 1(3): 144-150.
17.	Hewett PJ, Allardyce RA, Bagshaw PF, et al. Short-term outcomes of the australasian randomized clinical study comparing laparoscopic and conventional open surgical treatments for colon cancer: The ALCCaS Trial. Ann Surg, 2008, 248(5): 728-738.
18.	Meshikhes AW. Controversy of hand-assisted laparoscopic colorectal surgery. World J Gastroenterol, 2010, 16(45): 5662-5668.
19.	Aalbers AG, Biere SS, van Berge Henegouwen MI, et al. Hand-assisted or laparoscopic-assisted approach in colorectal surgery: a systematic review and meta-analysis. Surg Endosc, , 2008, 22(8): 1769-1780.
20.	Meijer DW, Bannenberg JJ, Jakimowicz JJ. Hand-assisted laparoscopic surgery. Surg Endosc, 2000, 14(10): 891-895.
21.	Leblanc F, Delaney CP, Ellis CN, I. Hand-assistedversus straight laparoscopic sigmoid colectomy on a training simulator: what is the difference? World J Surg, 2010, 34(12): 2909-2914.
22.	Moloo H, Haggar F, Grimshaw J, et al. Hand assisted laparoscopic surgeryversus conventional laparoscopy for colorectal surgery. Cochrane Database Syst Rev, 2010, 10(10): 1399-1400.
23.	Myers EA, Feingold DL, Arnell TD, et al. The rate for the use of hand-assisted laparoscopic methods is directly proportional to body mass index. Surg Endosc, 2014, 28(1): 108-115.

1. Theophilus M, Platell C, Spilsbury K. Long-term survival following laparoscopic and open colectomy for colon cancer: a meta-analysis of randomized controlled trials. Colorectal Dis, 2014, 16(3): O75-O81.
2. Boland JP, Kusminsky RE, They EH. Laparoscopic mini-laparotomy with manipulation: The middle path. Minim Invasive Ther Allied Technol, 2009, 18(2): 63-67.
3. Marcello PW, Fleshman JW, Milsom JW, et al. Hand-assisted laparoscopicvs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum, 2008, 51(6): 818-828.
4. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0. The Cochrane Collaboration. Available: www.cochrane-handbook.org Accessed 2 September 2012.
5. Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute. 2012. Available: .
6. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005, 5: 13.
7. Bae SU, Park JS, Choi YJ, et al. The role of hand-assisted laparoscopic surgery in a right hemicolectomy for right-sided colon cancer. Ann Coloproctol, 2014, 30(1): 11-17.
8. Ng LW, Tung LM, Cheung HY, et al. Hand-assisted laparoscopicversus total laparoscopic right colectomy: a randomized controlled trial. Colorectal Dis, 2012, 14(9): e612-e617.
9. Papaconstantinou HT, Sharp N, Thomas JS. Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg, 2011, 213(1): 72-80.
10. Vogel JD, Lian L, Kalady MF, et al. Hand-assisted laparoscopic right colectomy: how does it compare to conventional laparoscopy? J Am Coll Surg, 2011, 212(3): 367-372.
11. 吴殿超, 刘丽芳, 李华, 等. 手辅助腹腔镜与腹腔镜右半结肠切除术疗效比较. 中华临床医师杂志(电子版), 2013, 2(2): 185-186.
12. 孙小华, 唐岩. 腹腔镜手助与辅助技术在右半结肠癌根治术中的应用效果比较. 中国基层医药, 2013, 20(12): 1875-1876.
13. 李大伟. 手辅助腹腔镜与腹腔镜行右半结肠切除术临床效果比较. 中国现代医生, 2014, 52(13): 135-137.
14. 石刚, 董明, 宋纯, 等. 手助腹腔镜与全腹腔镜在右半结肠癌根治术中应用的前瞻性病例对照研究. 中国内镜杂志, 2015, 21(2): 113-116.
15. 邱辉忠, 徐徕, 牛备战, 等. 腹腔镜手助与辅助技术在右半结肠切除术中应用的对比研究. 中华胃肠外科杂志, 2011, 14(7): 545-548.
16. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc, 1991, 1(3): 144-150.
17. Hewett PJ, Allardyce RA, Bagshaw PF, et al. Short-term outcomes of the australasian randomized clinical study comparing laparoscopic and conventional open surgical treatments for colon cancer: The ALCCaS Trial. Ann Surg, 2008, 248(5): 728-738.
18. Meshikhes AW. Controversy of hand-assisted laparoscopic colorectal surgery. World J Gastroenterol, 2010, 16(45): 5662-5668.
19. Aalbers AG, Biere SS, van Berge Henegouwen MI, et al. Hand-assisted or laparoscopic-assisted approach in colorectal surgery: a systematic review and meta-analysis. Surg Endosc, , 2008, 22(8): 1769-1780.
20. Meijer DW, Bannenberg JJ, Jakimowicz JJ. Hand-assisted laparoscopic surgery. Surg Endosc, 2000, 14(10): 891-895.
21. Leblanc F, Delaney CP, Ellis CN, I. Hand-assistedversus straight laparoscopic sigmoid colectomy on a training simulator: what is the difference? World J Surg, 2010, 34(12): 2909-2914.
22. Moloo H, Haggar F, Grimshaw J, et al. Hand assisted laparoscopic surgeryversus conventional laparoscopy for colorectal surgery. Cochrane Database Syst Rev, 2010, 10(10): 1399-1400.
23. Myers EA, Feingold DL, Arnell TD, et al. The rate for the use of hand-assisted laparoscopic methods is directly proportional to body mass index. Surg Endosc, 2014, 28(1): 108-115.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of clinical outcomes between hand assisted laparoscopic and standard laparoscopic right hemicolectomy: a meta-analysis

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