Meta Analysis Of Hand-assisted Laparoscopic Versus Laparoscopic Colorectal Surgery

Aims:In recent years, minimally invasive operation has been widely carried out in the field of surgery, many kinds of laparoscopic operation have been applied in department of general surgery. Because colorectum has its unique intra-abdominal location, clear anatomical structure, moderate diameter, fixed vascular supply and lymphatic drainage, so it is favorable to the implementation of minimally invasive operation, With the application of minimally invasive treatment in colorectal surgery, more and more clinical doctors recognize that most of the traditional open colorectal operation can be replaced by minimally invasive operation, the clinical practice have improved that minimally invasive operation can obtain better short-term and long-term clinical effect than open operation. The current main clinical minimally invasive treatment were hand-assisted laparoscopic and conventional laparoscopic operation, but the effect of them has not an ultimate assessment. To evaluate the effect between hand-assisted laparoscopic and laparoscopic colorectal surgery. then we can guide the clinical work better.Methods:We search articles and papers those published from2000to now about the clinical comparison with hand-assisted laparoscopic and laparoscopic colorectal surgery inland and abroad through the keywords in Pubmed, Cochrane, Embase, Web Of Science. The articles searched including prospective randomized controlled trial and case-control study. Then make a quality evaluation of the articles, and then use the RevMan4.2make a systemic review and meta-analysis of the articles.Results:According to the criteria, finally26articles meet the criterion,4papers were randomized controlled trials,22papers were case-control study,3530patients entered into this study, the preoperative characteristic was no significant difference. The results show that compared with the laparoscopic group, hand-assisted laparoscopic group of intraoperative transit open rate is63%, Operation time reduce19.7minutes, Surgical incision lengthen2.01cm. Other intraoperative and postoperqative indicators have no statistical significance.Conclusion:The two kinds of operaton both can be selected in clinical work if the doctor acquired these skills. But the learning curve of hand assisted laparoscopic surgery is shorter than the laparoscopic operation, and the operation is relatively more simple, hand assisted laparoscopic surgery can be used as a bridge between open operation and laparoscopic operation.