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Therefore, we suggest that prudential interpretation around clinical significance rather than statistical
significance is considered. Most available studies included in our analysis are merely observational without
randomisation and are of retrospective design, the quality of which was assessed to be not very high based
on IHE assessment.

In conclusion, this systematic review and meta-analysis on the comparative studies between IA and EA
in laparoscopic colectomies has demonstrated IA can be safely considered by laparoscopic surgeons for
resection of benign and malignant pathology in right and left colon without compromising oncological
radicality. However, various limitations in the current data identified by this study need to be addressed by
high-quality randomised trials involving longer follow-up.

DECLARATIONS
Authors’ contributions
Study conception and design, data acquisition: Park SSW, Smith S
Data analysis and interpretation, drafting the article, critical revision of article, final approval of manuscript:
Park SSW, Feng D, Smith S

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

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