Outcomes of the Deloyers procedure: A systematic review and meta-analysis of proportions.

Abstract

Extended left hemicolectomies may result in a short transverse colon and excessive mesenteric tension, precluding a tension-free anastomosis. The Deloyers procedure is a colonic rotation technique that facilitates anastomosis without total colectomy. This study aimed to evaluate short-term outcomes following the Deloyers procedure in patients undergoing left-sided colorectal resections. A systematic review and meta-analysis were conducted using PubMed, Scopus and the Cochrane Central Register to identify observational studies published up to March 2025. Continuous outcomes were pooled as means with 95% confidence intervals (CIs) and binary outcomes as proportions. Heterogeneity was assessed using the I² statistic and Cochrane Q-test. All analyses were performed using R (v4.4.1). Thirteen studies including 287 patients undergoing the Deloyers procedure were analysed. The pooled mean operating time was 256.7 min (95% CI, 188.5-349.6), intraoperative blood loss was 327.5 mL (95% CI, 227.9-470.6) and the perioperative transfusion rate was 25% (95% CI, 16%-35%). Postoperative recovery outcomes included a mean hospital stay of 9.9 days (95% CI, 7.6-12.9), an ileus rate of 15% (95% CI, 7%-30%) and an average of 2.9 bowel movements per day (95% CI, 2.4-3.5). Reported complications included Clavien-Dindo grade I-II events in 36% of patients (95% CI, 14%-66%) and grade III-IV events in 12% (95% CI, 5%-24%). The pooled rate of surgical site infection was 13% (95% CI, 4%-34%), small bowel obstruction 6% (95% CI, 0%-35%) and anastomotic leakage 1% (95% CI, 0%-7%). The overall mortality rate was 0% (95% CI, 0%-1%), with two deaths reported in patients with significant comorbidities and advanced oncological disease. The Deloyers procedure is a feasible surgical alternative in patients requiring extended left-sided colectomy, providing acceptable operative times, functional recovery and complication rates. It may help avoid total colectomy in anatomically complex cases.