Laparoscopic Versus Open Transverse Colectomy: A Systematic Review and Meta-Analysis

• Published in: World journal of surgery 2018-09, Vol.42 (9), p.3008-3014
• Main Authors: Gavriilidis, Paschalis, Katsanos, Konstantinos
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adequacy; Cardiac Surgery; Colectomy - methods; Colon, Transverse; Colonic Neoplasms - surgery; Disease-Free Survival; Eating; General Surgery; Humans; Laparoscopy; Length of Stay; Medicine; Medicine & Public Health; Meta-analysis; Operative Time; Postoperative Period; Recovery; Recovery of Function; Scientific papers; Scientific Review; Search engines; Surgery; Survival; Survival Rate; Systematic review; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-018-4570-5

Objectives The survival benefits, oncological adequacy, effectiveness, and safety of laparoscopic transverse colectomy (LTC) were compared with that of open transverse colectomy (OTC) using a meta-analysis. Methods EMBASE, Medline, Cochrane library, and Google scholar databases were searched for the last 20 years. Meta-analyses were performed using both fixed-effects and random-effects models. Five-year disease-free survival and overall survival were estimated using the inverse variance hazard ratio method. Results No survival benefits were detected between the two LTC and OTC cohorts. OTC showed shorter operative time by 38 min compared to LTC [mean difference (MD) = 38(15.23–60.77), p  = 0.001]. However, LTC was associated with earlier postoperative recovery. The time to flatus and time to oral intake for LTC were MD = −1.12(−1.68 to −0.55, p  = 0.001) and MD = −1.57(−2.38 to −0.76, p  = 0.001), respectively. In addition, LTC was associated with a shorter hospital stay by 4.5 days [MD = −4.64(−7.52 to −1.75), p  = 0.002]. Conclusions Compared to OTC, LTC provides similar survival benefits, earlier postoperative recovery, and shorter hospital stay by 4.5 days.