Abstract
To evaluate the prognostic impact and describe suturing tools of mesenteric closure after laparoscopic right hemicolectomy (LRH), a scoping review was conducted. PubMed, Embase, Cochrane library, Web of Science, and Scopus databases were searched for publications relating to mesenteric closure data and tools. A total of 7 publications were identified, with 5 focused on prognostic impact and 4 referring to tools for mesenteric closure. All studies related to prognostic impact were single center with "low" modified GRADE quality. A high degree of heterogeneity was found. The evidence from current research does not support routine closure of mesenteric defects. Use of a polymer ligation clip has produced favorable results in a small sample size trial and further investigation is merited. A large randomized controlled trial is still warranted.
Key Questions
1. What is laparoscopic right hemicolectomy (LRH)?
Laparoscopic right hemicolectomy (LRH) is a minimally invasive surgical procedure to remove the right side of the colon. It is commonly used in colorectal surgery and has advantages over open surgery[1]. 2. What is mesenteric closure?
Mesenteric closure is the process of closing the mesenteric defects created during laparoscopic colorectal surgery. It may prevent the occurrence of internal hernia caused by the small intestine passing through the mesenteric defect[1]. 3. What are the main findings of this review regarding mesenteric closure in LRH?
The review found that current evidence does not support routine closure of mesenteric defects after LRH. There was a high degree of heterogeneity among studies, and all had "low" modified GRADE quality[1]. 4. What tool showed promising results for mesenteric closure?
The use of polymer ligation clips for mesenteric closure produced favorable results in a small sample size trial. However, further investigation is needed to confirm these findings[1]. 5. What future research is recommended?
The review suggests that a large randomized controlled trial is still warranted to provide more definitive evidence on the value of mesenteric closure after laparoscopic right hemicolectomy[1].
