Morbidity and mortality following laparoscopic-assisted right hemicolectomy for cancer.
OBJECTIVE
This study was undertaken to compare morbidity, mortality, and pathology after laparoscopically assisted right hemicolectomy (LARHC) or open right hemicolectomy (ORHC) for cancer of the right colon.


METHODS
Patients undergoing either LARHC or ORHC for invasive carcinoma of the right colon during a 30-month period were studied. Data were collected from two sources. All morbidity, mortality, and pathology data were collected prospectively in a form suitable for computer storage and analysis as part of the ongoing Concord Hospital Colorectal Cancer Registry. Data concerning in hospital course were obtained by casenote review.


RESULTS
Twenty-eight patients underwent LARHC, and 33 had an ORHC during the study period. The two groups were well matched with respect to age, sex, weight, associated comorbidities, and tumor stage. Mean operating room use time was significantly higher for LARHC (LARHC = 261 minutes; ORHC = 203 minutes; P < 0.001). Mean hospital stay from date of resection was the same in both groups (LARHC = 12 days; ORHC = 12.2 days). There was no significant difference between procedures with respect to postoperative complications, return of gastrointestinal function, or narcotic analgesic requirements. There was a significant shorter distal margin of resection in the LARHC group (ORHC = 13.4 cm; LARHC = 10 cm; P = 0.03). Total cost was significantly greater for LARHC ($9,064 vs. $7,881 (Australian); P < 0.001). Median follow-up was 23.4 months for the LARHC group and 23.9 months for the ORHC group. To date, there have been no local or port site recurrences.


CONCLUSIONS
Although there is no difference in morbidity and mortality following LARHC or ORHC, there is no apparent benefit for LARHC.
Bokey
E L
EL
Department of Colon and Rectal Surgery, University of Sydney, Concord Hospital, Australia.
Moore
J W
JW
Chapuis
P H
PH
Newland
R C
RC
D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery*; D003082:Colectomy / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000191:economics / Q000401:mortality; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D012189:Retrospective Studies