Safety and efficacy of overlapping triangular anastomoses in complete laparoscopic colorectal resection: a systematic evaluation and Meta-analysis

Abstract

Background To systematically evaluate and compare the safety and efficacy of overlapping triangular anastomoses and other anastomoses in total laparoscopic colorectal resection for the treatment of colorectal cancer, and to provide evidence-based medical evidence for clinical practice. Materials and methods PubMed, Embase, Cochrane Library and Web of Science databases were searched until May 2023, published literature related to total laparoscopic overlapping triangular anastomosis colorectal resection versus colorectal resection with other anastomoses was obtained, progressively screened, and eligible studies were included, and finally Meta-analysis was performed by Stata17 software. Results Seven literatures were included. 705 patients were included, including 342 patients who received overlapping triangular anastomoses and 363 patients who received other anastomoses. A meta-analysis of the included metrics showed that overlapping triangular anastomoses and other anastomoses were more effective in terms of operative time (SMD=-0.29, 95%CI-0.82, 0.23, P = 0.278), postoperative exhaust time (SMD=-0.61, 95%CI-0.84,-0.37), P = 0.000), intraoperative blood loss (SMD=-0.06, 95% CI-0.21,0.10, P = 0.493), length of hospital stay (SMD=-0.41, 95% CI-0.86,0.05, P = 0.079), incision length (SMD=-0.70, 95%CI-1.22,-0.19, P = 0.007), anastomosis time (SMD=-0.56, 95%CI-1.09,-0.03, P = 0.040), ground time (SMD=-0.33, 95%CI-0.65,-0.01, P = 0.041), postoperative defecation time (SMD=-0.75, 95%CI-1.39,-0.10, P = 0.023), number of lymph nodes dissection (SMD = 0.21, 95%CI-0.01,0.43, P = 0.063). From the results, it is clear that there was no significant difference between the overlapping triangular anastomosis and other anastomoses in terms of operative time, intraoperative bleeding, length of hospital stay, and number of lymph nodes discharged (P > 0.05). Compared with other anastomoses, the overlapping triangular anastomosis showed a significant difference in terms of shorter postoperative venting time, smaller incision length, shorter anastomosis time, earlier time on the floor, and earlier postoperative defecation time (P < 0.05). Conclusion The overlapping triangular anastomosis in complete laparoscopic colorectal resection is safe and effective, and is superior to other anastomoses in terms of postoperative venting time, incision length, and postoperative defecation time.