title: [Medial approach versus lateral approach in laparoscopic colorectal resection: a meta-analysis].
abstract: OBJECTIVE
  To compare the safety and efficacy of the medial approach(MA) and the lateral approach (LA) in the treatment of colorectal disease.
  
  
  METHODS
  Studies published from January 1994 to April 2013 that compared MA to LA in laparoscopic colorectal resection were collected. Publications in English were mainly identified from Medline, Embase, Cochrane Library, and those in Chinese from Wanfang database and CNKI database. Conversion rate, operative time, blood loss, number of harvested lymph nodes, hospital stay, complication, mortality, recurrence, and hospitalization costs of MA and LA were meta-analyzed using fixed-effect and random-effect models.
  
  
  RESULTS
  Five cohort studies (2 randomized controlled trials and 3 retrospective studies) including 881 patients were enrolled and analyzed. Of these patients, 416 and 465 underwent laparoscopic colorectal resection with MA and LA respectively. As compared to LA, MA had significantly lower conversion rate (OR=0.42, 95%CI:0.25-0.72, P=0.001), shorter operative time (WMD=-52.62, 95%CI:-63.23--42.01, P<0.01), less number of harvested lymph nodes (WMD=-1.17, 95%CI:-1.89--0.45, P=0.001), while blood loss was less and hospitalization cost lower. Significant differences in intraoperative complications and postoperative complications were not found between the two group (OR:0.57, 95%CI:0.15-2.18, P=0.41; OR:0.78, 95%CI:0.52-1.17, P=0.23).
  
  
  CONCLUSIONS
  Compared with LA, MA has the advantages of shorter operative time and lower conversion rate with similar safety. Differences in blood loss, hospitalization cost and oncological safety between the two approaches warrant further investigation.
authors.affiliation: Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China. guoqingliao@126.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Ding
authors.forename: Guoqing
authors.initials: G
authors.lastname: Liao
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Pan
authors.forename: Kaisheng
authors.initials: K
authors.lastname: Xu
authors.forename: Shaoyong
authors.initials: S
authors.lastname: Wang
authors.forename: Dongmiao
authors.initials: D
authors.lastname: Li
authors.forename: Zhongshu
authors.initials: Z
authors.lastname: Yan
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016737:Proctocolectomy, Restorative / Q000379:methods*