Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma.
OBJECTIVE
Laparoscopic surgery, especially laparoscopic rectal surgery, for colorectal cancer has been developed considerably. However, due to relatively complicated anatomy and high requirements for surgery techniques, laparoscopic right colectomy develops relatively slowly. This study was designed to compare the outcomes of laparoscopic right hemicolectomy (LRH) with open right hemicolectomy (ORH) in the treatment of colon carcinoma.


METHODS
Between September 2000 and February 2003, 30 patients with colon cancer who underwent LRH were compared with 34 controls treated by ORH in the same period. All patients were evaluated with respect to surgery-related complications, postoperative recovery, recurrence and metastasis rate, cost-effectiveness and survival.


RESULTS
Among 30 LRH, 2 (6.7%) were converted to open procedure. No significant differences were observed in terms of mean operation time, blood loss, post-operative complications, and hospital cost between LRH and ORH groups. Mean time for bowel movement, hospital stay, and time to resume early activity in the LRH group were significantly shorter than those in the ORH group (2.24+/-0.56 vs 3.25+/-1.29 d, 13.94+/-6.5 vs 18.25+/-5.96 d, 3.94+/-1.64 vs 5.45+/-1.82 d respectively, P<0.05). As to the lymph node yield, the specimen length and total cost for operation and drugs, there was no significant difference between the two groups. Local recurrence rate and metachronous metastasis rate had no marked difference between the two groups. Cumulative survival probability at 40 mo in LRH group (76.50%) was not obviously different compared to the ORH group (74.04%).


CONCLUSIONS
LRH in patients with colon cancer has statistically and clinically significant advantages over ORH. Thus, LRH can be regarded as a safe and effective procedure.
Zheng
Min-Hua
MH
Department of General Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. zmhtiger@yeah.net
Feng
Bo
B
Lu
Ai-Guo
AG
Li
Jian-Wen
JW
Wang
Ming-Liang
ML
Mao
Zhi-Hai
ZH
Hu
Yan-Yan
YY
Dong
Feng
F
Hu
Wei-Guo
WG
Li
Dong-Hua
DH
Zang
Lu
L
Peng
Yuan-Fei
YF
Yu
Bao-Ming
BM
D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome