Hand-Assisted Laparoscopic Surgery Versus Open Surgery in Patients Needed Total Colectomy: A Meta-analysis

This study is to evaluate intraoperative and postoperative outcomes of hand-assisted laparoscopic colectomy (HALC) and open colectomy in the management of patients needed to removal total colon or colorectum. A systematic literature search with no limits was performed in PubMed and the Cochrane Library. Estimated blood loss, operative time, length of hospital stay, and post-operation complications including ileus, wound infection and leak were extracted. Six researches reporting a total number of 271 patients who underwent HALC or open surgery within restorative proctocolectomy (RPC) or total abdominal colectomy (TAC) were included. There was a significant difference between HALC and open surgery groups in the estimated blood loss (mean difference (MD)=93.44, 95%CI [51.33, 135.54], p<0.0001), operative time (MD=-41.17, 95%CI [-54.41,-27.94], p<0.00001) and length of hospital stay (MD=1.56, 95%CI [0.24, 2.88], P=0.02). In the terms of post-operation complications, the incidence of ileus (OR 1.27, 95% CI [0.55, 2.95], P=0.57) and wound infection (OR 1.21, 95% CI [0.53, 2.79], P=0.66) were similar between the two groups. HALC could have more effect and safety over open surgery in patients underwent RPC and TAC.