Comparison of short-term outcomes between laparoscopically-assisted vs. transverse-incision open right hemicolectomy for right-sided colon cancer: a retrospective study.
BACKGROUND
Laparoscopically-assisted right hemicolectomy (LRH) is an acceptable alternative to open surgery for right-sided colon cancer which offers patients less pain and faster recovery. However, special equipment and substantial surgical experience are required. The aim of the study is to compare the short-term surgical outcomes of LRH and open right hemicolectomy through right transverse skin crease incision (ORHT) for right-sided colon cancer.


METHODS
This retrospective study included 33 patients with right-sided colon cancer who underwent elective right hemicolectomy by laparoscopic or open approaches through right transverse skin crease incision between March 2004 and September 2006 at the Department of Surgery, Faculty of Medicine Siriraj Hospital. Operative details, postoperative requirement of narcotics, recovery of bowel function, and oncological parameters were analyzed.


RESULTS
Thirteen patients underwent LRH and 20 patients underwent ORHT. Both approaches achieved adequate oncological resection of the tumor. The laparoscopic group were characterized by shorter average incision lengths (7.7 vs 10.3 cm; p < 0.001), but longer average operating times (208 vs 105 min; p < 0.001). There was no significant difference in the time to first bowel movement, time to defecation, and time to resumption of normal diet between both groups (59 vs 64 hr; p = 0.64, 3.2 vs 3.7 d; p = 0.25 and 3.9 vs 4.3 d; p = 0.39). There was no statistically significant difference in the time to discontinuation of intravenous nacrotics and the length of hospital stay (1.0 vs 1.4 d; p = 0.25 and 6.2 vs 7.1 d; p = 0.3).


CONCLUSIONS
LRH and ORHT for right-sided colon cancer resulted in the same short-term surgical outcomes including postoperative bowel function, narcotics consumption and length of hospital stay. However, LRH required a significantly longer operating time.
Lohsiriwat
Varut
V
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. sislr@mahidol.ac.th
Lohsiriwat
Darin
D
Chinswangwatanakul
Vitoon
V
Akaraviputh
Thawatchai
T
Lert-Akyamanee
Narong
N
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome