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16.09.2023 | Review Article

Comparison of the short-term and long-term outcomes of three different types of inferior mesenteric artery ligation in left colonic and rectal cancers: a network meta-analysis

verfasst von: Hao Zeng, Qilong Lan, Fudi Li, Dongbo Xu, Shuangming Lin

Erschienen in: Updates in Surgery | Ausgabe 8/2023

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Abstract

To perform a network meta-analysis of the literature to assess the short-term and long-term outcomes of three operations for left colon and rectal cancer. Electronic literature searches were performed in the PubMed, Web of Science, EMBASE, and Cochrane Central Register of Controlled Trials databases up to August 2022. A Bayesian network meta-analysis using R software, ADDIS, and Review Manager 5.4 was conducted to compare outcomes of high ligation of the inferior mesenteric artery(IMA),low ligation of the IMA with D2 dissection (LLD2), and low ligation of the IMA with D3 dissection (LLD3). Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Asymmetry of data was estimated by using Egger’s tests. Publication bias corrected by trimming and filling method. A total of 44 studies, 5 randomized clinical trials (RCTs) and 39 non-RCTs, were included in this meta-analysis. HL was associated with a higher risk of anastomotic leakage (HL vs. LLD2, OR = 1.35, 95% CI 1.13–3.25, P = 0.001; HL vs. LLD3, OR = 1.65, 95% CI 1.35–2.01, P < 0.001), and required a longer postoperative hospital stay (HL vs. LLD3, SMD = 0.28, 95%CI 0.09–0.48, P = 0.01).However HL showed an advantage in terms of operation time(HL vs. LLD3, SMD = − 0.13, 95%CI − 0.26 to 0.01, P = 0.04). LLD3 is most likely to rank best in terms of short-term and long-term outcomes after surgery for left colon and rectal cancer. Caution should be taken in the risk of anastomotic leakage when treating colorectal cancer with LLD2. HL, LLD2 and LLD3 provide similar overall survival rates for left colon and rectal cancer.

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Titel: Comparison of the short-term and long-term outcomes of three different types of inferior mesenteric artery ligation in left colonic and rectal cancers: a network meta-analysis
verfasst von: Hao Zeng
Qilong Lan
Fudi Li
Dongbo Xu
Shuangming Lin
Publikationsdatum: 16.09.2023
Verlag: Springer International Publishing
Erschienen in: Updates in Surgery / Ausgabe 8/2023
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-023-01631-3

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Comparison of the short-term and long-term outcomes of three different types of inferior mesenteric artery ligation in left colonic and rectal cancers: a network meta-analysis

Abstract

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