Yao Qing, Fu Ya-Yan, Sun Qian-Nan, Ren Jun, Wang Liu-Hua, Wang Dao-Rong
Dalian Medical University, Dalian, 116044, China.
Department of Gastrointestinal Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, Jiangsu, China.
J Cancer Res Clin Oncol. 2023 Nov;149(15):14341-14351. doi: 10.1007/s00432-023-05091-5. Epub 2023 Jul 29.
The feasibility and effectiveness of selecting an intracorporeal or extracorporeal technique in left hemicolectomy remain poorly understood. This meta-analysis aimed to evaluate the difference between the two approaches regarding intraoperative and postoperative outcomes.
A thorough exploration of online databases (PubMed, Embase, Cochrane, and Web of Science) was executed to identify randomized controlled trials, cohort studies, and case control studies. The outcomes contained four aspects: intraoperative outcomes, postoperative complications, postoperative patient conditions, and postoperative outcomes. All of these data were analyzed using RevMan 5.4. Seven retrospective control trials (intracorporeal, 396 patients; extracorporeal, 426 patients) were evaluated.
Compared to the extracorporeal group, the intracorporeal group demonstrated superiority in incision length (P = 0.005), overall complications (P = 0.01), time to first flatus (P < 0.001), time to first stool (P = 0.005), time to first diet (P < 0.001) and hospital stay duration (P = 0.001).
The intracorporeal technique is associated with superiority over the extracorporeal technique in reducing postoperative complications, promoting postoperative recovery of gastrointestinal function, and reducing hospital stay duration.
左半结肠切除术中选择体内或体外技术的可行性和有效性仍知之甚少。本荟萃分析旨在评估这两种方法在术中和术后结果方面的差异。
对在线数据库(PubMed、Embase、Cochrane和Web of Science)进行全面检索,以识别随机对照试验、队列研究和病例对照研究。结果包括四个方面:术中结果、术后并发症、术后患者状况和术后结局。所有这些数据均使用RevMan 5.4进行分析。评估了七项回顾性对照试验(体内组,396例患者;体外组,426例患者)。
与体外组相比,体内组在切口长度(P = 0.005)、总体并发症(P = 0.01)、首次排气时间(P < 0.001)、首次排便时间(P = 0.005)、首次进食时间(P < 0.001)和住院时间(P = 0.001)方面表现出优势。
体内技术在减少术后并发症、促进术后胃肠功能恢复和缩短住院时间方面优于体外技术。