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Laparoscopic sigmoid resection with transrectal specimen extraction: a systematic review
Author(s) -
Wolthuis A. M.,
Van Geluwe B.,
Fieuws S.,
Penninckx F.,
D’Hoore A.
Publication year - 2012
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.1463-1318.2011.02869.x
Subject(s) - medicine , sigmoid function , resection , general surgery , surgery , radiology , artificial intelligence , artificial neural network , computer science
Aim A systematic review was performed to identify differences in surgical technique, postoperative morbidity, length of hospital stay and safety for procedures involving left‐sided laparoscopic colectomy with natural orifice specimen extraction. Method A PubMed search was performed to retrieve studies reporting on left‐sided laparoscopic colorectal resection with transrectal specimen extraction. The quality of the different reports was assessed according to the Newcastle–Ottawa Scale. Six studies were included and all but one were cohort studies. Studies on transanal, transvaginal or transcolonic specimen extraction were excluded, as were reports on paediatric surgery. Results Six papers (including 94 patients) fulfilled the search criteria. The techniques reported were not standardized and this technical heterogeneity hampered pooled analysis. A meta‐analysis could also not be performed because of differences in inter‐study methods, study population and results. All studies showed, nevertheless, that the technique is feasible with low morbidity and short postoperative hospital stay. No anal dysfunction was reported. Conclusion To date, the evidence in favour of left‐sided laparoscopic colectomy with transrectal specimen extraction is weak (level IV–V). Future clinical research should focus on standardization of the technique. Randomized controlled trials are necessary to show the superiority of this approach with regard to postoperative pain and morbidity, hospital stay, recovery, function and cosmesis.