Hand-assisted Versus Laparoscopic Approach In Colorectal Surgery: A Meta-analysis

Objective: To compare the clinical therapeutic effect of hand-assistedlaparoscopic and laparoscopic approach in colorectal surgery with Meta-analysis.Methods: Comprehensive electronic search strategies were developedusing the following electronic databases: PubMed, EMBASE, Medline,CNKI,CBM，Wan Fang and FMJS. The Literature published before Januaryof2013was searched. The randomized controlled trials (RCTs) aboutcomparing hand-assisted laparoscopic and laparoscopic resection forcolorectal disease were included. A data-extraction sheet was developedbased on the preset standards. The data from eligible studies were pooledthrough Meta-analysis.Results: Five trials with a total of313patients met the inclusioncriteria. The meta-analysis showed that there was a statistical differencebetween hand-assisted laparoscopic group and the laparoscopic onconversion rate[OR0.30,95%CI(0.11,0.82), P＜0.05] and amount ofbleeding [WMD63.21,95%CI (46.00,80.43), P＜0.05]; No significant differences were found between the two groups in operation time,postoperative first flatus, in length of hospital stay, perioperative morbidity,Lymph node retrieval (P≥0.5).Conclusion: According to Limited evidence, there are some findingsas follows: It is feasibility, safety and effectiveness of hand-assisted laparo-scopic for colorectal surgery. Because of the limits of sample and quality,more large sample, high quality trials and multi-center are required to makea definite clinical evidence to use hand-assisted laparoscopic for colorectalsurgery.