Evidence map›Paper›PMID 30955074›Full record

SynthesisInternational journal of colorectal disease2019

Meta-analysis of medial-to-lateral versus lateral-to-medial colorectal mobilisation during laparoscopic colorectal surgery.

Shahin Hajibandeh, Shahab Hajibandeh, Ahmad Navid, Diwakar Ryali Sarma, Mokhtar Eltair, Rajnish Mankotia, Christopher Vaun Thompson, Andrew W Torrance, Rajeev Peravali

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Shahin HajibandehDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. shahin_hajibandeh@yahoo.com.
Shahab HajibandehDepartment of General Surgery, The Pennine Acute Hospitals NHS Trust, North Manchester General Hospital, Manchester, UK.
Ahmad NavidDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Diwakar Ryali SarmaDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Mokhtar EltairDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Rajnish MankotiaDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Christopher Vaun ThompsonDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Andrew W TorranceDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Rajeev PeravaliDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate comparative outcomes of medial-to-lateral and lateral-to-medial colorectal mobilisation in patients undergoing laparoscopic colorectal surgery.

methodsWe conducted a systematic search of electronic databases and bibliographic reference lists. Perioperative mortality and morbidity, procedure time, length of hospital stay, rate of conversion to open procedure, and number of harvested lymph nodes were the outcome parameters. Combined overall effect sizes were calculated using fixed-effects or random-effects models.

resultsWe identified eight comparative studies reporting a total of 1477 patients evaluating outcomes of medial-to-lateral (n = 626) and lateral-to-medial (n = 851) approaches in laparoscopic colorectal resection. The medial-to-lateral approach was associated with significantly lower rate of conversion to open (odds ratio (OR) 0.43, P = 0.001), shorter procedure time (mean difference (MD) - 32.25, P = 0.003) and length of hospital stay (MD - 1.54, P = 0.02) compared to the lateral-to-medial approach. However, there was no significant difference in mortality (risk difference (RD) 0.00, P = 0.96), overall complications (OR 0.78, P = 0.11), wound infection (OR 0.84, P = 0.60), anastomotic leak (OR 0.70, P = 0.26), bleeding (OR 0.60, P = 0.50), and number of harvested lymph nodes (MD - 1.54, P = 0.02) between two groups. Sub-group analysis demonstrated that the lateral-to-medial approach may harvest more lymph nodes in left-sided colectomy (MD - 1.29, P = 0.0009). The sensitivity analysis showed that overall complications were lower in the medial-to-lateral group (OR 0.72, P = 0.49).

conclusionsOur meta-analysis (level 2 evidence) showed that medial-to-lateral approach during laparoscopic colorectal resection may reduce procedure time, length of hospital stay and conversion to open procedure rate. Moreover, it may probably reduce overall perioperative morbidity. However, both approaches carry similar risk of mortality, and have comparable ability to harvest lymph nodes. Future high-quality randomised trials are required.

Indexed as

Colorectal SurgeryLaparoscopyAgedConversion to Open SurgeryFemaleHumansLength of StayLymph Node ExcisionMaleMiddle AgedObservational Studies as TopicPostoperative ComplicationsPublication BiasSensitivity and SpecificityColorectal mobilisationLaparoscopic colorectal surgeryLateral-to-medialMedial-to-lateral

Identifiers

PMID30955074

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.