Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma.
BACKGROUND
We report our preliminary experience in urgent laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma.


METHODS
From January to April 2005, seven consecutive patients with obstructing right-sided colon carcinoma underwent emergency laparoscopically assisted right or extended right hemicolectomy. Patient demographic data, operative details, and short-term clinical outcomes were prospectively collected and analyzed.


RESULTS
The median duration of obstructing symptoms prior to admission was 3 days (range, 1-6 days). Two patients underwent palliative resection and five patients underwent curative resection. The median operative time was 180 minutes (range, 125-350 minutes). There were no conversions to the open procedure. Median blood loss was 30 mL (range, negligible-300 mL). The median times to resuming diet, first bowel motion, and full ambulation were 4 days (range, 3-10 days), 5 days (range, 3-7 days), and 4 days (range, 4-5 days), respectively. The median duration of hospital stay was 7 days (range, 6-19 days). One patient with ischemic heart disease developed acute coronary syndrome postoperatively and died on postoperative day 19. The remaining patients had no complications. The median tumor length was 3.5 cm (range, 2-5 cm) and the median number of lymph nodes removed was 17 (range, 16-36).


CONCLUSIONS
Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma is feasible and safe, with favorable short-term clinical outcomes and an acceptable number of lymph nodes removed.
Ng
Simon S M
SS
Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. simonng@surgery.cuhk.edu.hk
Yiu
Raymond Y C
RY
Li
Jimmy C M
JC
Lee
Janet F Y
JF
Leung
Ka Lau
KL
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002432:Cecum / Q000601:surgery; D003082:Colectomy / Q000295:instrumentation / Q000379:methods; D044682:Colon, Ascending / Q000601:surgery; D044684:Colon, Transverse / Q000601:surgery; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D006723:Hong Kong; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome