Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis
Background and Aims. To investigate the clinical effect of preservation or nonpreservation of the left colic artery (LCA) in total mesorectal excision (TME) under laparoscopy. Methods. The words, like “rectal cancer,” “left colonic artery,” and “laparoscopy,” were used as the retrieval terms, and th...
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Wiley
2020-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/1958573 |
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| author | Jiefeng Liu Yujing Gong Miao He Xinyu Zeng Yiping Liu |
| author_facet | Jiefeng Liu Yujing Gong Miao He Xinyu Zeng Yiping Liu |
| author_sort | Jiefeng Liu |
| collection | DOAJ |
| description | Background and Aims. To investigate the clinical effect of preservation or nonpreservation of the left colic artery (LCA) in total mesorectal excision (TME) under laparoscopy. Methods. The words, like “rectal cancer,” “left colonic artery,” and “laparoscopy,” were used as the retrieval terms, and the keyword retrieval method was adopted. The retrieval period was set as from January 1, 2013, to June 1, 2018. We searched databases including PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) to collect randomized and controlled trials which compared the effect of preservation or nonpreservation of the LCA in TME under laparoscopy. Two researchers independently carried out literature screening, data extraction, and literature quality evaluation; Review Manager 5.3 was used for the meta-analysis. Results. Seven studies including 1467 cases were identified for the meta-analysis. As showed by the meta-analysis, compared with the LCA nonpreservation group, the LCA preservation group had significantly reduced incidence of anastomotic leakage (OR=0.44, CI=0.30,0.65, P<0.0001) and postoperative urinary and sexual dysfunction (OR=0.26, CI=0.09,0.78, P=0.02) and significantly shorter time for intestinal function recovery (WMD=−0.26, CI=−0.41,−0.11, P=0.0008). There were no significant differences between the two groups in the duration of surgery, blood loss, number of dissected lymph nodes, or postoperative hospital stay. Conclusions. From the results, the LCA preservation group seems to achieve comparable success with acceptable safety outcomes. Therefore, this surgical method can be recommended in the clinical practice. |
| format | Article |
| id | doaj-art-a957a5be804c4c87b9644959fe425db8 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-a957a5be804c4c87b9644959fe425db82025-02-03T01:05:13ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/19585731958573Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysisJiefeng Liu0Yujing Gong1Miao He2Xinyu Zeng3Yiping Liu4Department of General Surgery, The Fourth Hospital of Changsha, Hunan Normal University, Changsha, 410006 Hunan Province, ChinaDepartment of General Surgery, The Fourth Hospital of Changsha, Hunan Normal University, Changsha, 410006 Hunan Province, ChinaDepartment of General Surgery, The Fourth Hospital of Changsha, Hunan Normal University, Changsha, 410006 Hunan Province, ChinaDepartment of General Surgery, The Fourth Hospital of Changsha, Hunan Normal University, Changsha, 410006 Hunan Province, ChinaDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, 410078 Hunan Province, ChinaBackground and Aims. To investigate the clinical effect of preservation or nonpreservation of the left colic artery (LCA) in total mesorectal excision (TME) under laparoscopy. Methods. The words, like “rectal cancer,” “left colonic artery,” and “laparoscopy,” were used as the retrieval terms, and the keyword retrieval method was adopted. The retrieval period was set as from January 1, 2013, to June 1, 2018. We searched databases including PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) to collect randomized and controlled trials which compared the effect of preservation or nonpreservation of the LCA in TME under laparoscopy. Two researchers independently carried out literature screening, data extraction, and literature quality evaluation; Review Manager 5.3 was used for the meta-analysis. Results. Seven studies including 1467 cases were identified for the meta-analysis. As showed by the meta-analysis, compared with the LCA nonpreservation group, the LCA preservation group had significantly reduced incidence of anastomotic leakage (OR=0.44, CI=0.30,0.65, P<0.0001) and postoperative urinary and sexual dysfunction (OR=0.26, CI=0.09,0.78, P=0.02) and significantly shorter time for intestinal function recovery (WMD=−0.26, CI=−0.41,−0.11, P=0.0008). There were no significant differences between the two groups in the duration of surgery, blood loss, number of dissected lymph nodes, or postoperative hospital stay. Conclusions. From the results, the LCA preservation group seems to achieve comparable success with acceptable safety outcomes. Therefore, this surgical method can be recommended in the clinical practice.http://dx.doi.org/10.1155/2020/1958573 |
| spellingShingle | Jiefeng Liu Yujing Gong Miao He Xinyu Zeng Yiping Liu Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis Gastroenterology Research and Practice |
| title | Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis |
| title_full | Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis |
| title_fullStr | Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis |
| title_full_unstemmed | Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis |
| title_short | Clinical Effect of Preservation or Nonpreservation of Left Colic Artery in Total Mesorectal Excision under Laparoscopy: A Meta-analysis |
| title_sort | clinical effect of preservation or nonpreservation of left colic artery in total mesorectal excision under laparoscopy a meta analysis |
| url | http://dx.doi.org/10.1155/2020/1958573 |
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