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World Journal of Surgery
Published in: World Journal of Surgery 12/2019

01-12-2019 | Colon Cancer | Scientific Review

Laparoscopic Versus Open Complete Mesocolon Excision in Right Colon Cancer: A Systematic Review and Meta-Analysis

Authors: Mohamed Ali Chaouch, Mohamed Wejih Dougaz, Ibtissem Bouasker, Hichem Jerraya, Wafa Ghariani, Mehdi Khalfallah, Ramzi Nouira, Chadli Dziri

Published in: World Journal of Surgery | Issue 12/2019

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Abstract

Background

Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This systematic review and meta-analysis aimed to compare intraoperative, postoperative, and oncological outcomes after LCME and open total mesocolon excision (OCME) for right-sided colonic cancers.

Methods

Literature searches of electronic databases and manual searches up to January 31, 2019, were performed. Random-effects meta-analysis model was used. Review Manager Version 5.3 was used for pooled estimates.

Results

After screening 1334 articles, 10 articles with a total of 2778 patients were eligible for inclusion. Compared to OCME, LCME improves results in terms of overall morbidity (OR = 1.48, 95% CI 1.21 to 1.80, p = 0.0001), blood loss (MD = 56.56, 95% CI 19.05 to 94.06, p = 0.003), hospital stay (MD = 2.18 day, 95% CI 0.54 to 3.83, p = 0.009), and local (OR = 2.12, 95% CI 1.09 to 4.12, p = 0.03) and distant recurrence (OR = 1.63, 95% CI 1.23–2.16, p = 0.0008). There was no significant difference regarding mortality, anastomosis leakage, number of harvested lymph nodes, and 3-year disease-free survival. Open approach was significantly better than laparoscopy in terms of operative time (MD = − 34.76 min, 95% CI − 46.01 to − 23.50, p < 0.00001) and chyle leakage (OR = 0.41, 95% CI 0.18 to 0.96, p = 0.04).

Conclusions

This meta-analysis suggests that LCME in right colon cancer surgery is superior to OCME in terms of overall morbidity, blood loss, hospital stay, and local and distant recurrence with a moderate grade of recommendation due to the retrospective nature of the included studies.
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Metadata
Title
Laparoscopic Versus Open Complete Mesocolon Excision in Right Colon Cancer: A Systematic Review and Meta-Analysis
Authors
Mohamed Ali Chaouch
Mohamed Wejih Dougaz
Ibtissem Bouasker
Hichem Jerraya
Wafa Ghariani
Mehdi Khalfallah
Ramzi Nouira
Chadli Dziri
Publication date
01-12-2019
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 12/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05134-4

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