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The Journal of Surgical Research Jul 2022Globally, abdominal adhesions constitute a significant burden of morbidity and mortality. They represent the commonest complication of abdominal operations with a... (Review)
Review
INTRODUCTION
Globally, abdominal adhesions constitute a significant burden of morbidity and mortality. They represent the commonest complication of abdominal operations with a lifelong risk of multiple pathologies, including adhesive small bowel obstruction, female infertility, and chronic pain. Adhesions represent a problem of the entire abdomen, forming at the time of injury and progressing through multiple complex pathways. Clinically available preventative strategies are limited to barrier technologies. Significant knowledge gaps persist in the characterization and mitigation of the involved molecular pathways underlying adhesion formation. Thus, the objectives of this scoping review are to describe the known molecular pathophysiology implicated in abdominal adhesion formation and summarize novel preclinical regenerative medicine preventative strategies for potential future clinical investigation.
METHODS
A literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews. Included peer-reviewed publications were published within the last 5 y and contained in vivo preclinical experimental studies of postoperative adhesions with the assessment of underlying mechanisms of adhesion formation and successful therapy for adhesion prevention. Studies not involving regenerative medicine strategies were excluded. Data were qualitatively synthesized.
RESULTS
A total of 1762 articles were identified. Of these, 1001 records were excluded by the described screening criteria. Sixty-eight full-text articles were evaluated for eligibility, and 11 studies were included for review.
CONCLUSIONS
Novel and reliable preventative strategies are urgently needed. Recent experimental data propose novel regenerative medicine targets for adhesion prevention.
Topics: Abdomen; Female; Humans; Intestinal Obstruction; Intestine, Small; Postoperative Complications; Regenerative Medicine; Tissue Adhesions
PubMed: 35306261
DOI: 10.1016/j.jss.2022.02.005 -
BMC Gastroenterology Feb 2023Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Gastrointestinal strictures impact clinical presentation in abdominal tuberculosis and are associated with significant morbidity.
AIM
To conduct a systematic review of the prevalence of stricturing disease in abdominal and gastrointestinal tuberculosis and response to antitubercular therapy (ATT).
METHODS
We searched Pubmed and Embase on 13th January 2022, for papers reporting on the frequency and outcomes of stricturing gastrointestinal tuberculosis. The data were extracted, and pooled prevalence of stricturing disease was estimated in abdominal tuberculosis and gastrointestinal (intestinal) tuberculosis. The pooled clinical response and stricture resolution (endoscopic or radiologic) rates were also estimated. Publication bias was assessed using the Funnel plot and Egger test. The risk of bias assessment was done using a modified Newcastle Ottawa Scale.
RESULTS
Thirty-three studies reporting about 1969 patients were included. The pooled prevalence of intestinal strictures in abdominal tuberculosis and gastrointestinal TB was 0.12 (95%CI 0.07-0.20, I = 89%) and 0.27 (95% CI 0.21-0.33, I = 85%), respectively. The pooled clinical response of stricturing gastrointestinal tuberculosis to antitubercular therapy was 0.77 (95%CI 0.65-0.86, I = 74%). The pooled stricture response rate (endoscopic or radiological) was 0.66 (95%CI 0.40-0.85, I = 91%). The pooled rate of need for surgical intervention was 0.21 (95%CI 0.13-0.32, I = 70%), while endoscopic dilatation was 0.14 (95%CI 0.09-0.21, I = 0%).
CONCLUSION
Stricturing gastrointestinal tuberculosis occurs in around a quarter of patients with gastrointestinal tuberculosis, and around two-thirds of patients have a clinical response with antitubercular therapy. A subset of patients may need endoscopic or surgical intervention. The estimates for the pooled prevalence of stricturing disease and response to ATT had significant heterogeneity.
Topics: Humans; Constriction, Pathologic; Tuberculosis, Gastrointestinal; Antitubercular Agents; Intestinal Obstruction; Abdomen
PubMed: 36814249
DOI: 10.1186/s12876-023-02682-x -
The Cochrane Database of Systematic... Nov 2023A groin hernia is a collective name for inguinal and femoral hernias, which can present acutely with incarceration or strangulation of the hernia sac content, requiring... (Review)
Review
BACKGROUND
A groin hernia is a collective name for inguinal and femoral hernias, which can present acutely with incarceration or strangulation of the hernia sac content, requiring emergency treatment. Timely repair of emergency groin hernias is crucial due to the risk of reduced blood supply and thus damage to the bowel, but the optimal surgical approach is unclear. While mesh repair is the standard treatment for elective hernia surgery, using mesh for emergency groin hernia repair remains controversial due to the risk of surgical site infection.
OBJECTIVES
To assess the benefits and harms of mesh compared with non-mesh in emergency groin hernia repair in adult patients with an inguinal or femoral hernia.
SEARCH METHODS
On 5 August 2022, we searched the following databases: CENTRAL, MEDLINE Ovid, and Embase Ovid, as well as two trial registers for ongoing and completed trials. Additionally, we performed forward and backward citation searches for the included trials and relevant review articles. We searched without any language or publication restrictions.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) comparing mesh with non-mesh repair in emergency groin hernia surgery in adults. We included any mesh and any non-mesh repairs. All studies fulfilling the study, participant, and intervention criteria were included irrespective of reported outcomes.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methodology. We presented dichotomous data as risk ratios (RR) with 95% confidence intervals (CI). We based missing data analysis on best- and worst-case scenarios. For outcomes with sufficiently low heterogeneity, we performed meta-analyses using the random-effects model. We analysed subgroups when feasible, including the degree of contamination. We used RoB 2 for risk of bias assessment, and summarised the certainty of evidence using GRADE.
MAIN RESULTS
We included 15 trials randomising 1241 participants undergoing emergency groin hernia surgery with either mesh (626 participants) or non-mesh hernia repair (615 participants). The studies were conducted in China, the Middle East, and South Asia. Most patients were men, and most participants had an inguinal hernia (41 participants had femoral hernias). The mean/median age in the mesh group ranged from 35 to 70 years, and from 41 to 69 years in the non-mesh group. All studies were performed in a hospital emergency setting (tertiary care) and lasted for 11 to 139 months, with a median study duration of 31 months. The majority of the studies only included participants with clean to clean-contaminated surgical fields. For all outcomes, we considered the certainty of the evidence to be very low, mainly downgraded due to high risk of bias (due to deviations from intended intervention and missing outcome data), indirectness, and imprecision. Mesh hernia repair may have no effect on or slightly increase the risk of 30-day surgical site infections (RR 1.66, 95% CI 0.96 to 2.88; I² = 21%; 2 studies, 454 participants) when compared with non-mesh hernia repair, but the evidence is very uncertain. The evidence is also very uncertain about the effect of mesh hernia repair compared with non-mesh hernia repair on 30-day mortality (RR 1.38, 95% CI 0.58 to 3.28; 1 study, 208 participants). In summary, the results showed 70 more (from 5 fewer to 200 more) surgical site infections and 29 more (from 32 fewer to 175 more) deaths within 30 days of mesh hernia repair per 1000 participants compared with non-mesh hernia repair. The evidence is very uncertain about 90-day surgical site infections after mesh versus non-mesh hernia repair (RR 1.00, 95% CI 0.15 to 6.64; 1 study, 60 participants; very low-certainty evidence). No 30-day recurrences were recorded, and mesh hernia repair may not reduce recurrence within one year (RR 0.19, 95% CI 0.04 to 1.03; I² = 0%; 2 studies, 104 participants; very low-certainty evidence). Within 30 days of hernia repair, no meshes were removed from clean to clean-contaminated fields, but 6.7% of meshes (1 study, 208 participants) were removed from contaminated to dirty surgical fields. Among the four studies reporting 90-day mesh removal, no events occurred. We were not able to identify any studies reporting complications classified according to the Clavien-Dindo Classification or reoperation for complications within 30 days of repair.
AUTHORS' CONCLUSIONS
Our results show that in terms of 30-day surgical site infections, 30-day mortality, and hernia recurrence within one year, the evidence for the use of mesh hernia repair compared with non-mesh hernia repair in emergency groin hernia surgery is very uncertain. Unfortunately, firm conclusions cannot be drawn due to very low-certainty evidence and meta-analyses based on small-sized and low-quality studies. There is a need for future high-quality RCTs or high-quality registry-based studies if RCTs are unfeasible.
Topics: Male; Adult; Humans; Middle Aged; Aged; Female; Surgical Wound Infection; Hernia, Inguinal; Hernia, Femoral; Herniorrhaphy; Surgical Mesh; Groin
PubMed: 38009575
DOI: 10.1002/14651858.CD015160.pub2 -
Surgical Endoscopy Sep 2021In right-sided colon cancer surgery, currently there is a great deal of discussion and debate regarding complete mesocolic excision (CME) versus conventional right... (Review)
Review
Complete mesocolic excision and D3 lymphadenectomy with central vascular ligation in right-sided colon cancer: a systematic review of postoperative outcomes, tumor recurrence and overall survival.
BACKGROUND
In right-sided colon cancer surgery, currently there is a great deal of discussion and debate regarding complete mesocolic excision (CME) versus conventional right hemicolectomy (CRH) on postoperative outcomes and oncological results. Our aim was to perform a systematic review of the short- and long-term outcomes of CME to standardize surgical approach in patients with right-sided colon cancer.
METHODS
A systematic review was performed examining available data on randomized and non-randomized studies evaluating the role of CME and D3 lymphadenectomy in the treatment of right-sided colon cancer, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards.
RESULTS
After literature search, 919 studies have been recorded, 110 studies underwent full-text reviews and 30 studies met inclusion criteria. The total number of CME procedures was 5931. Postoperative complications was reported in 28 studies with pooled overall complications of 1.88% for CME surgery. Six studies reported 0% of overall postoperative complications and they demonstrated a low incidence of complications following CME procedure. Anastomotic leak was reported in 27 studies with pooled proportion of 0.92% after CME resections. There were 16 papers reporting overall survival following CME procedure, with a mean of 85% of patients survived at 5 years. Mean 5-year overall survival was 93.05% in stage I patients, 89.76% in stage II patients and 79.65% in stage III patients. Local and distant recurrence were included in 21 studies, reporting tumor recurrence rate of 12.25% following CME. 5-year tumor recurrence was 5.8% in stage I patients, 7.68% in stage II patients and 15.69% in stage III patients.
CONCLUSIONS
CME does not increase the risk of postoperative complications and significantly improves the long-term oncological impact. Prospective multicentre studies results are needed to verify if CME could be considered standard surgery for right colon cancer.
Topics: Colectomy; Colonic Neoplasms; Humans; Laparoscopy; Ligation; Lymph Node Excision; Mesocolon; Neoplasm Recurrence, Local; Prospective Studies; Treatment Outcome
PubMed: 33977376
DOI: 10.1007/s00464-021-08529-4 -
Ultrasound in Obstetrics & Gynecology :... Oct 2022The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of the sliding sign on transvaginal ultrasound (TVS) in detecting pouch of... (Meta-Analysis)
Meta-Analysis Review
Diagnostic accuracy of sliding sign for detecting pouch of Douglas obliteration and bowel involvement in women with suspected endometriosis: systematic review and meta-analysis.
OBJECTIVE
The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of the sliding sign on transvaginal ultrasound (TVS) in detecting pouch of Douglas obliteration and bowel involvement in patients with suspected endometriosis, using laparoscopy as the reference standard.
METHODS
A search for studies evaluating the role of the sliding sign in the assessment of pouch of Douglas obliteration and/or bowel involvement using laparoscopy as the reference standard published from January 2000 to October 2021 was performed in PubMed/MEDLINE, Web of Science, CINAHL, The Cochrane Library, ClinicalTrials.gov and SCOPUS databases. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of the studies. Analyses were performed using MIDAS and METANDI commands in STATA.
RESULTS
A total of 334 citations were identified. Eight studies were included in the analysis, resulting in 938 and 963 patients available for analysis of the diagnostic accuracy of the sliding sign for pouch of Douglas obliteration and bowel involvement, respectively. The mean prevalence of pouch of Douglas obliteration was 37% and the mean prevalence of bowel involvement was 23%. The pooled estimated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the sliding sign on TVS for detecting pouch of Douglas obliteration were 88% (95% CI, 81-93%), 94% (95% CI, 91-96%), 15.3 (95% CI, 10.2-22.9), 0.12 (95% CI, 0.07-0.21) and 123 (95% CI, 62-244), respectively. The heterogeneity was moderate for sensitivity and low for specificity for detecting pouch of Douglas obliteration. The pooled estimated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of the sliding sign on TVS for detecting bowel involvement were 81% (95% CI, 64-91%), 95% (95% CI, 91-97%), 16.0 (95% CI, 9.0-28.6), 0.20 (95% CI, 0.10-0.40) and 81 (95% CI, 34-191), respectively. The heterogeneity for the meta-analysis of diagnostic accuracy for bowel involvement was high.
CONCLUSION
The sliding sign on TVS has good diagnostic performance for predicting pouch of Douglas obliteration and bowel involvement in women with suspected endometriosis. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Topics: Douglas' Pouch; Endometriosis; Female; Humans; Laparoscopy; Sensitivity and Specificity; Ultrasonography
PubMed: 35289968
DOI: 10.1002/uog.24900 -
Heliyon Feb 2022The COVID-19 pandemic has impacted all aspects of people's lives, with many tasks and services now being delivered online in the aim of reducing contact and preventing... (Review)
Review
INTRODUCTION
The COVID-19 pandemic has impacted all aspects of people's lives, with many tasks and services now being delivered online in the aim of reducing contact and preventing further transmission of the disease. This has resulted in the increase in the use of portable electronic devices (i.e., mobile phones, smartphones, laptops), which emit different frequencies of electromagnetic field (EMF) radiation. However, the evidence on the harmful impacts of EMF radiation exposure on the human body, particularly on the abdomen of the female body during pregnancy, is scarce. Further, the related studies in the literature have yet to be systematically reviewed. If unmanaged, the absorption of EMF radiation by the maternal abdomen during pregnancy is associated with serious birth and infant outcomes.
PURPOSE
This study aimed to systematically review the published studies on the direct effects of EMF radiation emitted from mobile phones on pregnancy, birth, and infant outcomes.
METHODS
After a systematic search using the PRISMA guidelines, a total of 18 articles were retrieved from 5 databases. Studies which addressed the negative outcomes of EMF radiation exposure on mothers, adults, and children's health were included. The research articles were then sorted based on whether their findings were related to the impacts of EMF on physiological or pregnancy outcomes.
RESULTS
The findings of this review showed that EMF radiation exposure is associated with hormonal, thermal, and cardiovascular changes among adults. However, the reviewed studies did not consider the impacts of EMF radiation exposure on pregnancy outcomes specifically, which makes it difficult to draw conclusions from this review. Only four of the reviewed studies were conducted among pregnant women. These studies reported that EMF radiation exposure during pregnancy is associated with miscarriages and fluctuations in the fetal temperature and heart rate variability, as well as infant anthropometric measures.
CONCLUSIONS
More research should be conducted to identify the specific impacts of EMF radiation exposure on pregnancy, birth, and infant outcomes. Healthcare providers and researchers are recommended to collaborate to improve public health through public education and updated organizational policies to limit these environmental risks by encouraging the use of safe technologies.
PubMed: 35155842
DOI: 10.1016/j.heliyon.2022.e08915 -
Diseases of the Colon and Rectum Jan 2022Combined treatment modality of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is emerging as an alternative option for colorectal peritoneal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Combined treatment modality of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is emerging as an alternative option for colorectal peritoneal metastases, but there is ambiguity regarding patient selection, treatment protocols, and efficacy.
OBJECTIVE
To elaborate on the patient characteristics, hyperthermic intraperitoneal chemotherapy protocol and health outcomes in colorectal peritoneal metastases patients undergoing a combination of hyperthermic intraperitoneal chemotherapy and cytoreductive surgery and provide guidance for future studies.
DATA SOURCES
A Medline search for English language studies published between 2004 and 2019.
STUDY SELECTION
Medical subject headings and key terms, including: hyperthermic intraperitoneal chemotherapy, colorectal peritoneal metastases, colorectal cancer and combinations thereof as per guidelines.
MAIN OUTCOME MEASURES
Overall survival, disease-free survival, and morbidity and mortality rates.
RESULTS
Of the 26 included studies, 42% were published between 2016 and 2019. More than half of the studies were retrospective in nature and conducted in tertiary specialized centers outside of the United States. The median age range was 44 to 62 years. Mitomycin C-based therapy was seen in 50% of studies. Mean weighted median disease-free survival for 11 studies was 15 months (9 to 36 months). Median OS ranged from 12 to 63 months, with an average of 33.6 months among 20 studies. Overall morbidity varied from 11% to 56%, with a weighted mean of 29% in 18 studies. Mortality ranged from 0 to 34%, with a weighted mean of 4% in 15 studies.
LIMITATIONS
Despite careful study selection, variability in methodology of the included studies can limit review findings.
CONCLUSION
Due to study heterogeneity, and a recent large, randomized trial showing no overall benefit, use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in colorectal peritoneal metastases patients is highly controversial. Further standardized controlled studies can help uniformly define and build consensus among the medical community on patient eligibility and the optimal hyperthermic intraperitoneal chemotherapy techniques.
PROSPERO
Registered on March 3, 2020, CRD42020146942.
Topics: Adult; Antibiotics, Antineoplastic; Colorectal Neoplasms; Combined Modality Therapy; Cytoreduction Surgical Procedures; Disease-Free Survival; Female; Humans; Hyperthermic Intraperitoneal Chemotherapy; Male; Middle Aged; Mitomycin; Morbidity; Mortality; Neoplasm Metastasis; Outcome Assessment, Health Care; Peritoneum; Retrospective Studies; United States
PubMed: 34636780
DOI: 10.1097/DCR.0000000000002315 -
Frontiers in Medicine 2022Diverticular disease of the colon represents a common clinical condition in the western world. Its prevalence increases with age and only 5% of cases occur in adults...
BACKGROUND
Diverticular disease of the colon represents a common clinical condition in the western world. Its prevalence increases with age and only 5% of cases occur in adults younger than 40 years of age, making it a rare condition during pregnancy. The aim of this review was to provide an overview of the reported cases of diverticulitis during pregnancy.
METHODS
We conducted a systematic review of the literature based on preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. We searched three different electronic databases namely PubMed, Scopus and Web of Science from inception to December 2021. Literature search and data extraction were completed in duplicates.
RESULTS
The initial search yielded 564 articles from which 12 were finally included in our review. Ten articles were case reports and two were observational studies. The mean age of the cases was 34 years. The presenting complain was provided for 11 cases. The majority of the patients (10/11, 91%) presented with abdominal pain located mainly on the left (6/11, 55%) or right (4/11, 36%) iliac fossa. The most common diagnostic modality used for the diagnosis of the condition was ultrasonography in nine cases (9/12, 75%) followed by magnetic resonance imaging (MRI) in two cases (2/12, 17%). In spite of clinical and radiological evaluation, the initial diagnosis was inaccurate in seven cases (7/12, 58%). The therapeutic approach was available for 11 cases and it was based on the administration of intravenous antibiotics in six cases (6/11, 55%) and surgical management in five cases (5/11, 45%). Data for the type of delivery was provided in nine studies with five patients (5/9, 56%) delivering vaginally and four patients (4/9, 44%) delivering with cesarean section.
CONCLUSION
As advanced maternal age becomes more common, the frequency of diverticulitis in pregnancy may increase. Although available guidelines do not exist, the clinical awareness, early recognition of the disorder, using diagnostic modalities such as ultrasound and MRI, and rapid therapeutic approach with antibiotics, may improve maternal and neonatal outcomes.
PubMed: 36438049
DOI: 10.3389/fmed.2022.942666 -
International Journal of Colorectal... Jun 2023Complete mesocolic excision (CME) consists of the complete removal of tumor-bearing soft tissues enveloped by the mesocolic fascia and radical lymphadenectomy at the... (Review)
Review
BACKGROUND
Complete mesocolic excision (CME) consists of the complete removal of tumor-bearing soft tissues enveloped by the mesocolic fascia and radical lymphadenectomy at the origin of feeding vessels. We conducted a systematic review, evaluating the efficacy of the robotic CME (RCME) in patients with right-sided colon cancer and presenting the data in comparison to those concerning the open RC (right colectomy) with CME.
METHODS
One independent researcher searched the MEDLINE-PubMed database for published and unpublished material.
RESULTS
Eighty-three articles were found to refer to CME, 17 of which met the selection criteria following the PRISMA guidelines. All researchers presented short-term outcomes and agreed on the oncologic safety of CME. Different surgical approaches were proposed; however, no significant differences were noticed regarding the peri-operative outcomes.
CONCLUSION
Although long-term outcomes are needed to establish it as a standard of care in right-sided colon cancer, RCME is a procedure that gains more and more grounds due to its oncologic safety. The standard medial-to-lateral approach seems to have similar results to other approaches.
Topics: Humans; Robotic Surgical Procedures; Mesocolon; Lymph Node Excision; Colonic Neoplasms
PubMed: 37382665
DOI: 10.1007/s00384-023-04477-8 -
Techniques in Coloproctology Oct 2021The introduction of complete mesocolic excision (CME) for right colon cancer has raised an important discussion in relation to the extent of colic and mesenteric... (Meta-Analysis)
Meta-Analysis Review
Right hemicolectomy with complete mesocolic excision is safe, leads to an increased lymph node yield and to increased survival: results of a systematic review and meta-analysis.
BACKGROUND
The introduction of complete mesocolic excision (CME) for right colon cancer has raised an important discussion in relation to the extent of colic and mesenteric resection, and the impact this may have on lymph node yield. As uncertainty remains regarding the usefulness of and indications for right hemicolectomy with CME and the benefits of CME compared with a traditional approach, the purpose of this meta-analysis is to compare the two procedures in terms of safety, lymph node yield and oncological outcome.
METHODS
We performed a systematic review of the literature from 2009 up to March 15th, 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two hundred eighty-one publications were evaluated, and 17 met the inclusion criteria and were included. Primary endpoints analysed were anastomotic leak rate, blood loss, number of harvested lymph nodes, 3- and 5-year oncologic outcomes. Secondary outcomes were operating time, conversion, intraoperative complications, reoperation rate, overall and Clavien-Dindo grade 3-4 postoperative complications.
RESULTS
In terms of safety, right hemicolectomy with CME is not inferior to the standard procedure when comparing rates of anastomotic leak (RR 0.82, 95% CI 0.38-1.79), blood loss (MD -32.48, 95% CI -98.54 to -33.58), overall postoperative complications (RR 0.82, 95% CI 0.67-1.00), Clavien-Dindo grade III-IV postoperative complications (RR 1.36, 95% CI 0.82-2.28) and reoperation rate (RR 0.65, 95% CI 0.26-1.75). Traditional surgery is associated with a shorter operating time (MD 16.43, 95% CI 4.27-28.60) and lower conversion from laparoscopic to open approach (RR 1.72, 95% CI 1.00-2.96). In terms of oncologic outcomes, right hemicolectomy with CME leads to a higher lymph node yield than traditional surgery (MD 7.05, 95% CI 4.06-10.04). Results of statistical analysis comparing 3-year overall survival and 5-year disease-free survival were better in the CME group, RR 0.42, 95% CI 0.27-0.66 and RR 0.36, 95% CI 0.17-0.56, respectively.
CONCLUSIONS
Right hemicolectomy with CME is not inferior to traditional surgery in terms of safety and has a greater lymph node yield when compared with traditional surgery. Moreover, right-sided CME is associated with better overall and disease-free survival.
Topics: Colectomy; Colonic Neoplasms; Humans; Laparoscopy; Lymph Node Excision; Lymph Nodes; Mesocolon; Treatment Outcome
PubMed: 34120270
DOI: 10.1007/s10151-021-02471-2