Laparoscopic versus open right hemicolectomy: a comparison of short-term outcomes.
BACKGROUND
The laparoscopic approach is increasingly becoming the gold standard for colorectal resections. While laparoscopic surgery of the left colon and rectum has been evaluated in many studies, laparoscopic resection of the right colon has not been as widely examined. The aim of this study was to examine the short-term outcomes after laparoscopic right hemicolectomies and to determine if they were superior when compared with those after open resection.


METHODS
Consecutive cases of laparoscopic right hemicolectomies performed between May 2005 and December 2007, in the Department of Colorectal Surgery, Singapore General Hospital, were compared with a matched series of patients who underwent open surgery.


RESULTS
From a total of 37 laparoscopic cases, 36 patients successfully underwent laparoscopic right hemicolectomies. There was one conversion, giving a conversion rate of 2.7%. These 37 patients were compared with 40 patients who underwent open right hemicolectomies. The laparoscopic arm was characterised by shorter length of incisions (5.7 vs. 11.2 cm, p < 0.001) but longer operating times (110.8 vs. 71.6 min, p < 0.001). Mean number of lymph nodes harvested and length of proximal and distal margins were similar in both groups. There were also no significant differences between the groups in terms of narcotic use, recovery of bowel function, length of stay, post-operative morbidity and 30-day mortality.


CONCLUSIONS
Laparoscopic right hemicolectomies are as feasible and safe as the open technique. They confer improved cosmesis with smaller incisions but at the expense of longer operating time.
Tan
Wah-Siew
WS
Department of Colorectal Surgery, Singapore General Hospital, Outram Road, 169608 Singapore, Singapore.
Chew
Min-Hoe
MH
Ooi
Boon-Swee
BS
Ng
Kheng-Hong
KH
Lim
Jit-Fong
JF
Ho
Kok-Sun
KS
Tang
Choong-Leong
CL
Eu
Kong-Weng
KW
D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003710:Demography; D004032:Diet; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome