Top

International Journal of Colorectal Disease

Published in:

01-09-2013 | Review

Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis

Authors: Francesco Feroci, Elisa Lenzi, Alessia Garzi, Andrea Vannucchi, Stefano Cantafio, Marco Scatizzi

Published in: International Journal of Colorectal Disease | Issue 9/2013

Abstract

Purpose

The aim of this systematic review was to compare intracorporeal (IA) versus extracorporeal anastomosis (EA) after laparoscopic right hemicolectomy for cancer.

Methods

The meta-analysis was conducted following all aspects of the Cochrane Handbook for systematic reviews and Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Studies published from 2009 to 2012 that compare IA and EA after laparoscopic right hemicolectomy were identified. The included non-randomized studies were assessed for their methodological quality using the revised and modified grading system of the Scottish Intercollegiate Guidelines Network. Intraoperative, early postoperative, and postoperative recovery outcomes were compared using weighted mean differences and odds ratios.

Results

Five non-randomized controlled trials published between 2009 and 2011, comprising 425 patients, were included in this analysis. IA was associated with significant faster bowel movement, faster first flatus, shorter time to solid diet, decreased use of analgesics, and shorter duration of the hospital stay. No differences were observed for nasogastric tube reintroduction rate, operative time, incision length, number of nodes harvested, intraoperative complications, mortality, non-surgical site complications, surgical site complications (anastomotic leakage, anastomotic bleeding, wound infection, ileus), reintervention, and readmission rate.

Conclusions

Even when the limitations are taken into account due to the observational nature of the included studies, the results suggest that the IA after laparoscopic right hemicolectomy for cancer results in better postoperative recovery outcomes, such as shorter hospital stay, faster bowel movement recovery, faster first flatus, faster time to solid diet, and lesser analgesic usage.

Available only for authorised users

Schlinkert RT (1991) Laparoscopic-assisted right hemicolectomy. Dis Colon Rectum 34:1030–1031PubMedCrossRef

Tinmouth J, Tomlinson G (2004) Laparoscopically assisted versus open colectomy for colon cancer. N Engl J Med 351(9):933–934PubMedCrossRef

Guillou P, Quirke P, Thorpe H, Walker J, Jaine DG, Smith AM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre randomized controlled trial. Lancet 365:1718–1726PubMedCrossRef

Lacy AM, Garcia-Valdecasas JC, Pique JM, Delgado S, Campo E, Bordas JM (1995) Short term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer. Surg Endosc 9:1101–1105PubMed

The COLOR Study Group (2000) COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer. Dig Surg 17:617–622CrossRef

Rea JD, Cone MM, Diggs BS, Deveney KE, Lu KC, Herzig DO (2011) Utilization of laparoscopic colectomy in the United States before and after the clinical outcomes of surgical therapy study group trial. Ann Surg 254(2):281–288PubMedCrossRef

Rondelli F, Trastulli S, Avenia N, Schillaci G, Cirocchi R, Gullà N, Mariani E, Bistoni G, Noya G (2012) Is laparoscopic right colectomy more effective than open resection? A meta-analysis of randomized and nonrandomized studies. Colorectal Dis 8:447–469CrossRef

Jamali FR, Soweid AM, Dimassi H, Bailey C, Leroy J, Marescaux J (2008) Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 143(8):762–767PubMedCrossRef

Hellan M, Anderson C, Pigazzi A (2009) Extracorporeal versus intracorporeal anastomosis for laparoscopic right hemicolectomy. JSLS 13(3):312–317PubMed

10.

Scatizzi M, Kröning KC, Borrelli A, Andan G, Lenzi E, Feroci F (2010) Extracorporeal versus intracorporeal anastomosis after laparoscopic right colectomy for cancer: a case–control study. World J Surg 34(12):2902–2908PubMedCrossRef

11.

Fabozzi M, Allieta R, Contul RB, Grivon M, Millo P, Lale-Murix E, Nardi M Jr (2010) Comparison of short- and medium-term results between laparoscopically assisted and totally laparoscopic right hemicolectomy: a case–control study. Surg Endosc 24(9):2085–2091PubMedCrossRef

12.

Grams J, Tong W, Greenstein AJ, Salky B (2010) Comparison of intracorporeal versus extracorporeal anastomosis in laparoscopic-assisted hemicolectomy. Surg Endosc 24(8):1886–1891PubMedCrossRef

13.

Chaves JA, Idoate CP, Fons JB, Oliver MB, Rodríguez NP, Delgado AB, Lizoain JL (2011) A case–control study of extracorporeal versus intracorporeal anastomosis in patients subjected to right laparoscopic hemicolectomy. Cir Esp 89(1):24–30PubMedCrossRef

14.

Moher D, Liberati A, Tetzlaff J et al (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8:336–341PubMedCrossRef

15.

Chapman AL, Morgan LC, Gartlehner G (2010) Semi-automating the manual literature search for systematic reviews increases efficiency. Health Info Libr J 27:22–27PubMedCrossRef

16.

SIGN guidelines. Available at http://www.sign.ac.uk/guidelines/fulltext/50/checklist3.html. Accessed August 2012

17.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62(10):e1–e34PubMedCrossRef

18.

Mantel N, Haenszel W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22:719–748PubMed

19.

Bergamaschi R, Schochet E, Haughn C, Burke M, Reed JF, Arnaud JP (2008) Standardized laparoscopic intracorporeal right colectomy for cancer: short-term outcome in 111 unselected patients. Dis Colon Rectum 51(9):1350–1355PubMedCrossRef

20.

Casciola L, Ceccarelli G, Di Zitti L, Valeri R, Bellochi R, Bartoli A, Barbieri F, Spaziani A, D'Ajello M (2003) Laparoscopic right hemicolectomy with intracorporeal anastomosis. Technical aspects and personal experience. Minerva Chir 58(4):621–627PubMed

21.

Ikeda T, Kabasima A, Ueda N, Yonemura Y, Ninomiya M, Nogami M, Fujii K, Mashino K, Tashiro H, Sakata H (2012) Totally laparoscopic colectomy with intracorporeal anastomosis achieved using a laparoscopic linear stapler: experience of a single institute. Surg Today 42(1):41–45PubMedCrossRef

22.

Raftopoulos I, Courcoulas AP, Blumberg D (2006) Should completely intracorporeal anastomosis be considered in obese patients who undergo laparoscopic colectomy for benign or malignant disease of the colon? Surgery 140(4):675–682PubMedCrossRef

23.

Reza MM, Blasco JA, Andradas E, Cantero R, Mayol J (2006) Systematic review of laparoscopic versus open surgery for colorectal cancer. Br J Surg 93:921–928PubMedCrossRef

24.

Abraham NS, Byrne CM, Young JM, Solomon MJ (2007) Meta-analysis of non-randomized comparative studies of the short-term outcomes of laparoscopic resection for colorectal cancer. ANZ J Surg 77:508–516PubMedCrossRef

25.

Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef

26.

Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy AM (2005) Colon cancer Laparoscopic or Open Resection Study Group (COLOR). Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484PubMedCrossRef

27.

Bonjer HJ, Hop WC, Nelson H et al (2007) Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis. Arch Surg 142:298–303PubMedCrossRef

28.

Schwenk W, Haase O, Neudecker J, Muller JM (2005) Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev CD003145

29.

Fingerhut A, Ata T, Chouillard E, Alexakis N, Veyrie N (2007) Laparoscopic approach to colonic cancer: critical appraisal of the literature. Dig Dis 25:33–43PubMedCrossRef

30.

Kuhry E, Schwenk WF, Gaupset R, Romild U, Bonjer HJ (2008) Long-term results of laparoscopic colorectal cancer resection. Cochrane Database Syst Rev CD003432

31.

Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie A, Fitzgerald A (2011) Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev 9:CD004320

32.

Lang RA, Hüttl TP, Winter H, Meyer G, Jauch KW (2005) How safe are laparoscopic intracorporeal anastomoses? Zentralbl Chir 130(1):65–70PubMedCrossRef

33.

Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Short term quality-of-life outcomes after laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. Jama 287:321–328PubMedCrossRef

34.

Senagore AJ, Delaney CP, Brady KM, Fazio VW (2004) Standardized approach to laparoscopic right colectomy: outcomes in 70 consecutive cases. J Am Coll Surg 199:675–679PubMedCrossRef

35.

Edge SB, Byrd DR, Compton CC et al (2010) AJCC Cancer Staging Manual, 7th edn. Springer, New York

36.

Monson JR (2000) Invited editorial. Dis Colon Rectum 43:271–272CrossRef

37.

Doi SA, Barendregt JJ, Onitilo AA (2012) Methods for the bias adjustment of meta-analyses of published observational studies. J Eval Clin Pract. Jul 29

Title: Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis
Authors: Francesco Feroci
Elisa Lenzi
Alessia Garzi
Andrea Vannucchi
Stefano Cantafio
Marco Scatizzi
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 9/2013
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-013-1651-7

ACC 2024 Congress

Springer Medicine

Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2013

Assessment of anti-prothrombin antibodies in thrombosis complicating inflammatory bowel diseases

The incidence of mucinous appendiceal malignancies: a population-based study

CSF leak from epidural catheter site: a nightmare turned into reality

Mucus and adiponectin deficiency: role in chronic inflammation-induced colon cancer

Infliximab administration prior to surgery does not increase surgical site infections in patients with ulcerative colitis

Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance