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World Journal of Surgery

, Volume 43, Issue 12, pp 3179–3190 | Cite as

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

  • Mohamed Ali ChaouchEmail author
  • Mohamed Wejih Dougaz
  • Ibtissem Bouasker
  • Hichem Jerraya
  • Wafa Ghariani
  • Mehdi Khalfallah
  • Ramzi Nouira
  • Chadli Dziri
Scientific Review

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.

Abbreviations

LCME

Laparoscopic complete mesocolon excision

OCME

Open complete mesocolon excision

CME

Complete mesocolon excision

RCTs

Randomized clinical trials

CCTs

Controlled clinical trials

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  1. 1.Department B of SurgeryCharles Nicolle HospitalTunisTunisia

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