Abstract
Background and Objectives: There is general agreement on the benefits of laparoscopy for treatment of rectal and left colon cancers, whereas findings regarding the comparison of laparoscopic and open right colonic resections are discordant. The aim of this systematic review and meta-analysis was to assess the outcomes and advantages of laparoscopic versus transverse-incision open surgery for management of right colon cancer. Materials and Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Comparative studies evaluating the results of laparoscopic and transverse-incision open right hemicolectomies were analyzed. The measured outcomes were mean operative time, time to feeding, duration of hospital stay, and number of lymph nodes harvested. Results: A total of 5 studies including 318 patients met the inclusion criteria. Meta-analysis revealed no differences in time to resume oral feeding, hospital stay, and number of lymph nodes harvested in between groups, but mean length of surgery was significantly longer in the laparoscopic group. Conclusion: These data confirm that the preferred approach to right hemicolectomy is yet unclear. Laparoscopy has a longer operative time than transverse-incision open surgery, and no significant short-term benefits were observed for the studied parameters. Well-designed randomized control trials (RCTs) might help to identify the differences between these two techniques for the surgical treatment of right colon cancer.
Highlights
The advantages of laparoscopy for rectal and left-sided cancers are well documented [1,2,3,4], but the optimal surgical technique for right colectomy is still unclear [5,6]
A systematic electronic search of published items from January 1990 to December 2020 was conducted in the PubMed, Web of Science (WOS), and Scopus repositories, using the following keywords: “right colectomy” AND “laparoscopy” or “right colectomy” AND “laparotomy”
We found five retrospective comparative studies on this topic, including a total of 318 patients submitted to right hemicolectomy for colon cancer in the majority of cases; 157 were treated with laparoscopy and 161 received a transverse laparotomy
Summary
The advantages of laparoscopy for rectal and left-sided cancers are well documented [1,2,3,4], but the optimal surgical technique for right colectomy is still unclear [5,6]. A few studies, nonrandomized and including small populations, have compared laparoscopic to open right colonic resections, with no clear advantage of one approach over the other. The aim of this systematic review and meta-analysis was to assess the outcomes and advantages of laparoscopic versus transverse-incision open surgery for management of right colon cancer. Meta-analysis revealed no differences in time to resume oral feeding, hospital stay, and number of lymph nodes harvested in between groups, but mean length of surgery was significantly longer in the laparoscopic group. Well-designed randomized control trials (RCTs) might help to identify the differences between these two techniques for the surgical treatment of right colon cancer
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