Meta Analysis Of Hand-assisted Laparoscopic Versus Laparoscopic Colorectal Surgery

Objectives In recent years, minimally invasive techniques in the field of colorectal surgery has been widely carried out, has been recognized by more and more surgeons and confirmed by clinical and laparoscopic surgery can than traditional open surgery better short-term and long-term clinical effect. With the continuous improvement of laparoscopic technology, its advantages are becoming more and more obvious. Current clinical celiac minimally invasive surgery are mainly hand assisted laparoscopic and conventional laparoscopic surgery in two ways, hand assisted laparoscopic is combining the greatest degree of laparoscopic surgery and traditional open surgery, is gradually accepted by more and more people, application is becoming more and more popular.Research confirms the two can achieve good operation effect, but the advantages and disadvantages of clinical effect between the two remains controversial. This study intends to use meta analysis method, on the clinical effect of two kinds of minimally invasive surgery in colorectal surgery, evaluation system, and provide the basis for the clinical operation mode selection and promotion.Methods Literature retrieval strategy computer retrieval database in Chinese and English, including Pub Med, Cochrane Library, EMBASE, MEDLINE, FMJS, Wanfang database, CNKI, VIP data, Chinese biomedical database. English search terms include:Hand-assisted laparoscopic surgery, laparoscopic surgery, laparoscopic resection, colon surgery, rectum surgery, colorectal surgery, colorectal disease resection; Chinese retrieval words including the Hand-assisted laparoscopic surgery, laparoscopic surgery,laparoscopic resection, colon surgery, rectum surgery, colorectal surgery, colorectal disease resection And retrieval of literature reference, two retrieval. The retrieval period from 2000 to June 2015. Using statistical software Rev Man for systematic evaluation and meta analysis, the results of hand assisted laparoscopic and conventional laparoscopic surgery in colorectal surgery were compared.Results According to the inclusion criteria, a total of 29 articles were included, of which RCT 6 documents, non RCT 23 literatures, Meta analysis results showed that:(1)laparoscopic group was more than hand assisted laparoscopic group in the operation time(WMD=-17.44, 95%CI:-23.42 ~-11.46, P < 0.00001);(2) hand assisted laparoscopic group during surgery the amount of bleeding compared to laparoscopic group had no statistical significance(WMD=3.87, 95%CI:-23.76- 31.50, P=0.78);(3) in the length of incision hand assisted laparoscopic laparoscopic group leader Yu Danchun(WMD=1.81,95%CI:1.04- 2.58, P < 0.00001);(4) hand assisted laparoscopic postoperative hospital stay in laparoscopic group(longer than WMD=0.26, 95%CI:0.11- 0.41, P=0.0005);(5)hand assisted laparoscopic group in open abdominal number less than laparoscopic group(OR=0.57, 95%CI:0.36- 0.90, P=0.002);(6) hand assisted abdominal cavity There was no significant difference in the postoperative complications(OR=1.0, 95%CI:0.84 ~ 1.18,P=1.00) between the group and the group.Conclusions Hand assisted laparoscopic simple comparison of laparoscopic surgery,short operation time, intraoperative laparotomy rate is low, in intraoperative hemorrhage volume and postoperative complications between the two had no significant difference,can achieve operation result and simple laparoscopic surgery is safe and feasible. The operation difficulty of hand assisted laparoscopic surgery compared with laparoscopic surgery is relatively smaller, shorter learning curve, can be used as a bridge from the traditional open surgery to clinicians over simple laparoscopic operation.