Randomised controlled trials (RCTs), controlled studies and comparative studies (including case matched studies) that compared laparoscopic-assisted colectomy with hand-assisted laparoscopic surgery for benign or malignant colorectal disease were eligible for inclusion in the review. Primary outcomes included operating time, conversion to open surgery, length of hospital stay and postoperative (overall) morbidity. Secondary outcomes included cost, estimated intraoperative blood loss, incision length, number of trocars used, postoperative pain, (in-hospital) mortality, oncological results and time to return of gut function.
Procedures were categorised as segmental colectomy and proctocolectomy. Three studies compared hand-assisted laparoscopic surgery (combined with an open proctectomy and pouch creation via the Pfannenstiel) with total laparoscopic restorative proctocolectomy (including laparoscopic rectum extirpation). Three of the included studies exclusively or predominantly included patients with diverticulitis; other studies included patients with colonic and rectal cancer.
Two reviewers independently selected studies for the review. Any disagreements were resolved through discussion.