Evidence based medicine and surgical approaches for colon cancer: Evidences, benefits and limitations of the laparoscopic vs open resection

Figure 1 Study design. Study design according to the PRISMA statement for systematic reviews and meta-analysis.

Figure 2 Randomized studies. A: Randomized trails comparing laparoscopy and open surgery. X in the table refers to a statistical association provided in the studies; B: Meta-analysis of the out-come measures; C: Forest plot graph regarding studies investigating blood loss. Lap arm: Laparoscopy arm; OS arm: Open surgery arm; FU: Mean follow-up; OT: Operative time; BF: Bowel function; OI: Oral intake; PP: Post-operative Pain; BL: Blood loss; HOSP: Hospital stay; LNH: Lymph node harvest; NS: Not significant.

Figure 3 Non-randomized studies. A: Case-control studies comparing laparoscopy and open surgery. X in the table refers to a statistical association provided in the studies; B: Meta-analysis of the out-come measures; C: Forest plot graph regarding studies investigating hospital stay. ¹Statistic analysis not performed; ²Significant difference of follow-up according to the stage of the disease. Lap: Laparoscopy; OS: Open surgery; FU: Mean follow-up; OT: Operative time; BF: Bowel function; OI: Oral intake; PP: Post-operative Pain; BL: Blood loss; HOSP: Hospital stay; LNH: Lymph node harvest; NS: Not significant.

Figure 4 Right sided colectomies. A: Studies comparing right-side laparoscopy colectomy and open surgery. X in the table refers to a statistical association provided in the studies; B: Meta-analysis of the out-come measures; C: Forest plot graph regarding studies investigating operative time. ¹Statistic analysis not performed; ²Exclusively if patients > 75 years old; ³Exclusively if patients < 75 years old. Lap: Laparoscopy; OS: Open surgery; M: Midline incision; T: transverse incision R: Randomized, CC: Case-control; FU: Mean follow-up; OT: Operative time; BF: Bowel function; OI: Oral intake; PP: Post-operative Pain; BL: Blood loss; HOSP: Hospital stay; LNH: Lymph node harvest; NS: Not significant.

Figure 5 Left sided colectomies. A: Studies comparing left-side laparoscopy colectomy and open surgery. X in the table refers to a statistical association provided in the studies; B: Meta-analysis of the out-come measures; C: Forest plot graph regarding studies investigating morbidity rate. ¹Exclusively if patients > 75 years old. Lap: Laparoscopy; OS: Open surgery; M: Midline incision; T: transverse incision R: Randomized, CC: Case-control; FU: Mean follow-up; OT: Operative time; BF: Bowel function; OI: Oral intake; PP: Post-operative Pain; BL: Blood loss; HOSP: Hospital stay; LNH: Lymph node harvest; NS: Not significant.

Figure 6 Transverse colectomies. Studies comparing transverse laparoscopy colectomy and open surgery. X in the table refers to a statistical association provided in the studies. Lap: Laparoscopy; OS: Open surgery; M: Midline incision; T: transverse incision; R: Randomized; CC: Case-control; OT: Operative time; BF: Bowel function; OI: Oral intake; PP: Post-operative Pain; BL: Blood loss; HOSP: Hospital stay; LNH: Lymph node harvest; NS: Not significant.

Figure 7 Costs analysis. A: Studies comparing laparoscopy and open surgery: analysis of the costs; B: Meta-analysis; C: Forest plot graph. Lap: Laparoscopy; OS: Open surgery; NS: Not significant; R: Randomized; CC: Case-control.