title: [Hand-assisted laparoscopic versus laparoscopic-assisted right hemicolectomy: a clinical controlled study].
abstract: OBJECTIVE
  To compare the outcomes of right hemicolectomy performed either by the hand-assisted laparoscopic(HALS) or conventional laparoscopic surgery(LAS).
  
  
  METHODS
  Ninety-five patients undergoing HALS(n=47) from March 2002 to November 2006 or by LAS (n=48) from January 2007 to December 2009 were retrospectively studied. All the operations were performed by the same surgical team. Patient safety, postoperative recovery, complications, oncologic outcomes, medical expenses, and the follow-up results were compared between the two groups.
  
  
  RESULTS
  No severe complications or perioperative deaths were oberved. There were significant differences between the two groups in terms of intraoperative bleeding, operative time, and length of incision(all P<0.05). However, the conversion rate, intraoperative injuries, time to first bowel movement, postoperative bed-rest time, hospital stay, time to first oral intake, and the number of patients requiring postoperative analgesia were comparable between the two groups(P>0.05). Length of surgical specimen was (25.6±9.9) cm in the HALS group and was (26.8±7.9) cm in the LAS group, the diffenence was not statistically significant(P<0.05). The mean number of lymph nodes retrieved in HALS group was 18.2±12.1, which was significantly lower than that in LAS group(24.1±9.3, P<0.05). The medical expense of the LAS group was (28 049.8±7576.1) RMB, which was significantly higher than that of the HALS group(21 132.7±5323.4) RMB(P<0.05). A follow-up rate of 93.7% was achieved in the HALS group with 3 patients lost to follow-up. The follow-up duration ranged from 45.4 to 101.9 months with a median of 66.7 months. In LAS group, the follow-up rate was 96% with 2 patients lost to follow-up and the follow-up duration ranged from 12.4 to 45.7 months with a median of 21.6 months. There was no significant difference in 3-year disease-free survival(91.3% vs. 87.9%, P>0.05) between the two groups.
  
  
  CONCLUSIONS
  HALS and LAS can achieve similar minimal invasiveness efficacy and oncologic outcomes for right hemicolectomy.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China. qiuhzpumc@yahoo.com.cn
authors.forename: Hui-zhong
authors.initials: HZ
authors.lastname: Qiu
authors.forename: Lai
authors.initials: L
authors.lastname: Xu
authors.forename: Bei-zhan
authors.initials: BZ
authors.lastname: Niu
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.forename: Guo-le
authors.initials: GL
authors.lastname: Lin
authors.forename: Yi
authors.initials: Y
authors.lastname: Xiao
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome