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Laparoscopic surgery for ulcerative colitis – a meta‐analysis
Author(s) -
Tan J. J. Y.,
Tjandra J. J.
Publication year - 2006
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2006.00971.x
Subject(s) - medicine , proctocolectomy , ulcerative colitis , colectomy , surgery , meta analysis , laparoscopy , laparoscopic surgery , complication , strictly standardized mean difference , medline , general surgery , randomized controlled trial , disease , political science , law
Objective To assess the safety and feasibility of laparoscopic surgery for patients with ulcerative colitis. Methods A search of published studies in English between January 1992 and September 2005 was obtained, using the MEDLINE and PubMed databases and the Cochrane Central Register of Controlled Trials. Two independent assessors reviewed the studies using a standardized protocol. Where raw data, means and standard deviations were available, meta‐analysis was performed using the Forest plot review. Studies where medians and ranges were presented were separately analysed. Results The duration of surgery for laparoscopic and open procedures were similar (weighted mean difference 62.92 min, P = 0.19). Patients were able to tolerate oral intake significantly earlier, with a weighted mean difference of 1.39 days ( P = 0.002), but recovery of bowel function was similar (weighted mean difference 0.73 days, P = 0.36). The length of hospital stay was shorter for patients who had undergone laparoscopic surgery, with a weighted mean difference of 2.64 days ( P = 0.003). The complication rate was higher in open colectomy, compared to laparoscopic colectomy (67.6% vs 39.7%, P = 0.005). For restorative proctocolectomy, complication rates were comparable between the laparoscopic and open groups ( P = 0.25). Conclusions The time taken to perform laparoscopic surgery is similar to open surgery. Patients are able to tolerate oral intake earlier, and have a shorter hospitalization. Laparoscopic colectomy was safer compared to the open procedure, but both were equally safe for patients who had restorative proctocolectomy. Thus, laparoscopic surgery for ulcerative colitis is both safe and feasible.