Short-term outcomes of laparoscopic complete mesocolic excision versus noncomplete mesocolic excision for right colon cancer: a systematic review and meta-analysis

Background The benefit of laparoscopic complete mesocolic excision (LCME) is conflicting in terms of short-term outcomes when compared with laparoscopic non-complete mesocolic excision (LNCME) for right colon cancer. Herein, we performed a meta-analysis to elucidate the safety and efficacy of LCME and LNCME. Methods We searched PubMed, Embase, and the Cochrane Library databases for studies addressing the effects of LCME versus LNCME up to February 2021. Randomized controlled trials (RCTs) and retrospective studies which compared LCME with LNCME were included. Results Two RCTs and 6 retrospective studies with a total of 1925 patients met our search criteria and were assessed. 922 patients underwent LCME and 1003 patients underwent LNCME. Although LCME was associated with a longer operative time (weighted mean difference [WMD]: 14.26 min; 95% confidence interval [CI] 4.56 to 23.96; p = 0.004), patients in this group might benefit from less intraoperative blood loss (WMD: 11.30 ml; 95%CI -19.93 to -2.68; p = 0.01), a greater number of harvested lymph nodes (WMD: 6.82; 95%CI 4.04 to 9.59; p < 0.001), and a longer length of specimens (WMD: 2.74; 95%CI 0.59 to -4.90; p = 0.01). There were no significant differences in conversion rate, overall postoperative complications, Clavien-Dindo grade III-V complications, anastomotic leakage, ileus, pulmonary problem, wound infection, length of hospital stay, or length of proximal and distal resection margin. Conclusion In the current study, implementation of LCME does not increase the risk of postoperative complications. Randomized controlled trials of high quality are needed to validate our results in the future.