title: Intracorporeal Versus Extracorporeal Anastomosis in Laparoscopic Right Colectomy: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To compare intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in laparoscopic right colectomy (LRC) in terms of intraoperative and postoperative outcomes.
  
  
  METHODS
  A systematic literature search with no limits was performed in PubMed and Embase. The last search was performed on April 9, 2016. The outcomes of interests included intraoperative outcomes (operative time, blood loss, length of incision, conversion, lymph nodes harvested, and intraoperative complications) and postoperative outcomes (time to first flatus, time to first defecation, time to liquid diet, length of hospital stay, postoperative complications, mortality, ileus, anastomotic leakage, anastomotic bleeding, wound infection, hernia, and intra-abdominal abscess).
  
  
  RESULTS
  Fifteen articles and four conference abstracts published between 2004 and 2016 with a total of 1957 patients were enrolled in this meta-analysis. IA was associated with significant less blood loss, smaller length of incision, shorter time to first defecation, shorter time to liquid diet, and shorter length of hospital stay. No differences were found for operative time, conversion, lymph nodes harvested, intraoperative complications, time to first flatus, postoperative complications, mortality, anastomotic leakage, anastomotic bleeding, ileus, wound infection, intra-abdominal abscess, or hernia between IA and EA.
  
  
  CONCLUSIONS
  Our meta-analysis suggests that the IA for LRC improves cosmesis and results in better postoperative recovery outcomes without increasing intraoperative and postoperative complications. Furthermore, a large randomized control study is warranted to compare the short-term and long-term outcomes of those two anastomosis techniques.
authors: 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .|2 West China School of Medicine, Sichuan University , Chengdu, China .
authors: Qingbin
authors: Q
authors: Wu
authors: 3 Department of Gastrointestinal Surgery, The Fifth People's Hospital of Chengdu , Chengdu, China .
authors: Chengwu
authors: C
authors: Jin
authors: 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .|2 West China School of Medicine, Sichuan University , Chengdu, China .
authors: Tao
authors: T
authors: Hu
authors: 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .|4 State Key Laboratory of Biotherapy and Cancer Center/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University , Chengdu, China .
authors: Mingtian
authors: M
authors: Wei
authors: 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University , Chengdu, China .
authors: Ziqiang
authors: Z
authors: Wang
mesh_terms: D018784:Abdominal Abscess / Q000453:epidemiology; D000714:Anastomosis, Surgical / Q000379:methods*; D057868:Anastomotic Leak / Q000453:epidemiology; D003082:Colectomy / Q000379:methods*; D044682:Colon, Ascending / Q000601:surgery*; D006801:Humans; D045823:Ileus / Q000453:epidemiology; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008197:Lymph Node Excision; D008198:Lymph Nodes; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011184:Postoperative Period; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome
keywords: extracorporeal anastomosis; intracorporeal anastomosis; laparoscopic right colectomy; outcomes