title: Emergency laparoscopic-assisted versus open right hemicolectomy for obstructing right-sided colonic carcinoma: a comparative study of short-term clinical outcomes.
abstract: BACKGROUND
  The aim of the present study was to compare the clinical outcomes of emergency laparoscopic-assisted versus open right hemicolectomy for obstructing right-sided colonic carcinoma.
  
  
  METHODS
  Between July 2003 and July 2006, 43 consecutive patients with obstructing right-sided colonic carcinoma underwent emergency right hemicolectomy at our institution, 14 with the laparoscopic-assisted approach and 29 with the open approach. Clinical data were retrospectively recorded and compared between the two groups.
  
  
  RESULTS
  There were no significant differences between the two groups with respect to age, gender, co-morbidities, duration of obstructing symptoms, tumor length, and tumor staging. The laparoscopic-assisted group had longer operative time than the open group (187.5 min versus 145 min; p=0.034) but less blood loss (20 ml versus 100 ml; p=0.020). The median time to full ambulation was significantly shorter in the laparoscopic-assisted group (4 days versus 6 days; p=0.016), but the time to return of gastrointestinal function and the duration of hospital stay were similar between the two groups. More patients in the open group developed postoperative complications (55.2% versus 28.6%), but the difference was not statistically significant.
  
  
  CONCLUSIONS
  Emergency laparoscopic-assisted right hemicolectomy for obstructing right-sided colonic carcinoma is feasible and safe. In comparison with the open approach, the laparoscopic-assisted procedure is associated with less blood loss, earlier ambulation, and possibly lower morbidity rate.
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. simonng@surgery.cuhk.edu.hk
authors.forename: Simon S M
authors.initials: SS
authors.lastname: Ng
authors.forename: Janet F Y
authors.initials: JF
authors.lastname: Lee
authors.forename: Raymond Y C
authors.initials: RY
authors.lastname: Yiu
authors.forename: Jimmy C M
authors.initials: JC
authors.lastname: Li
authors.forename: Wing Wa
authors.initials: WW
authors.lastname: Leung
authors.forename: Ka Lau
authors.initials: KL
authors.lastname: Leung
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome