Efficacy and safety of hybrid laparo-endoscopic surgery for colon tumors (systematic review and meta-analysis)

Alexey V. Kolosov, S. Achkasov, E. Surovegin, R. Y. Khryukin, A. Likutov, O. Sushkov
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Abstract

Aim: to compare the efficacy and safety of hybrid laparo-endoscopic operations and laparoscopic segmental colectomy for benign endoscopically non-removable colorectal tumors.Materials and Methods: systematic review and meta-analysis included 17 studies which evaluate the results of hybrid laparo-endoscopic procedure (main group) and laparoscopic segmental colectomy (control group). The study included 835 patients — 517 in main group and 318 controls.Results: operation time was significantly lower in main than in control group (mean difference = −38,7 minutes; 95% CI: −51,4 — −26, p < 0,00001). There was significant difference in postoperative hospital stay. It was shorter in main group (mean difference = −2,3 days; 95% CI: −3,17 — −1,57, p < 0,00001). There was not significant difference between odds ratio of postoperative morbidity (OR = 0,7; 95% CI: 0,38–1,53, p = 0,44), mortality (OR = 0,4; 95% CI: 0,07–3,11, p = 0,43) and local recurrence rate as well (OR = 2,8; 95% CI: 0,68–11,35, p = 0,15).Conclusion: the hybrid laparo-endoscopic technique patients with benign endoscopically non-removable colon tumors does not increase the postoperative morbidity and mortality. At the same time, the hybrid technology reduces the operation time and postoperative hospital stay.
腹腔镜-内镜混合手术治疗结肠肿瘤的有效性和安全性(系统回顾和荟萃分析)
材料和方法:系统回顾和荟萃分析纳入了17项研究,这些研究评估了混合腹腔镜手术(主要组)和腹腔镜结肠分段切除术(对照组)的结果。研究共纳入 835 名患者,其中主刀组 517 人,对照组 318 人。结果:主刀组的手术时间明显少于对照组(平均差异 = -38.7 分钟;95% CI:-51.4 - -26,P < 0.00001)。术后住院时间有明显差异。主要组的住院时间更短(平均差异 = -2,3天;95% CI:-3,17 - -1,57, p < 0,00001)。术后发病率(OR = 0.7;95% CI:0.38-1.53,P = 0.44)、死亡率(OR = 0.4;95% CI:0.07-3.11,P = 0.43)和局部复发率(OR = 2.8;95% CI:0.68-11.35,P = 0.15)的几率比差异不大。结论:腹腔镜-内镜混合技术不会增加良性内镜下不可切除结肠肿瘤患者的术后发病率和死亡率。同时,混合技术缩短了手术时间和术后住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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