Comparison between transverse mini-incision and longitudinal mini-incision for the resection of locally advanced colonic cancer

[Intracorporeal anastomosis in laparoscopic right hemicolectomy: a review of evidence and a single-center experience]

Laparoscopic colon resections are currently becoming a standart method of surgical treatment of colon cancer. Long-term oncologic outcomes of such procedures are shown to be non-inferior to outcomes of traditional open surgery, while short-term results and morbidity profile are more favourable. The current direction of colon mini-invasive surgery development is to make procedures more easily tolerable by patients, using less traumatic methods and operative approaches. The article contains a review of one of such methods, which allows less traumatic performance of laparoscopic right hemicolectomy - an intracorporeal ileotransversoanastomosis. The current evidence concerning safety and efficacy are reviewed, when authors' own data are also brought to support implementation of this method into routine practice.

Enhanced recovery program versus traditional care after hepatectomy: A meta-analysis

To assess the safety and efficacy of enhanced recovery after surgery (ERAS) as compared with the traditional care in patients undergoing liver surgery and optimization of enhanced recovery programs.Literature, until August 2016, was searched to identify the comparative studies evaluating preoperative hospital stay time, complications, and C-reactive protein (CRP). Pooled odds ratios (OR) or weighted mean differences (WMDs) were calculated with either the fixed or random effect model.These studies included a total of 524 patients: 254 treated with ERAS and 270 with traditional care. The postoperative recovery time and length of hospital stay were significantly better than the control group (WMD -2.72; 95% confidence interval [CI] -3.86 to -1.57; WMD -2.67; 95% CI -3.68 to -1.65, respectively). The overall complications, grade I, and Grand II-V complications were significantly favorable to the ERAS group (OR, 0.45 [95% CI, 0.30-0.67]; OR, 0.55 [95% CI, 0.31-0.98]; OR, 0.49 [95% CI, 0.32-0.76], respectively). The concentration of CRP in the control group was significantly higher than that in the ERAS group on postoperative day 5 (WMD -21.68; 95% CI -29.30 to -14.05). Time to first flatus (WMD -0.93; 95% CI -1.41 to -0.46) was significantly shortened in the ERAS group.The evidence indicates that ERAS following liver surgery is safe, effective, and feasible. Therefore, further are essential for optimizing the ERAS protocols.