title: Comparative Study on Therapeutic Efficacy Between Hand-Assisted Laparoscopic Surgery and Conventional Laparotomy for Acute Obstructive Right-Sided Colon Cancer.
abstract: BACKGROUND
  This retrospective study aims to compare open colectomy and hand-assisted laparoscopic surgery (HALS) in the management of acute obstructive right-sided colon cancer and to analyze and evaluate the feasibility and safety of HALS.
  
  
  METHODS
  Ten consecutive patients who underwent hand-assisted laparoscopic right hemicolectomy due to acute obstructive right-sided colon cancer were retrospectively well matched with 25 patients scheduled for a conventional laparotomy during the same time. Demographic, intraoperative, and postoperative data were assessed.
  
  
  RESULTS
  The HALS group had the advantage in the length of incision (5.8±0.7 cm) over the conventional group (16±2.3 cm) (P<.05), and the mean blood loss during the operations was significantly less in the HALS group (30±15.2 mL) than in the laparotomy group (90±29.4 mL) (P<.05). Moreover, the time of postoperative ambulation was earlier (2.5±0.8 days versus 3.2±0.9 days) (P<.05). Seven cases underwent intestinal decompression for severe intestinal dilatation and had a satisfactory result. The hand-assisted device can fairly meet the demands of a minimally invasive operation and can protect the abdominal incision and avoid infection. There was no intergroup difference in complication rate, although the conventional group had a higher rate.
  
  
  CONCLUSIONS
  In this study, compared with conventional laparotomy for acute obstructive right-sided colon neoplasm, HALS is associated with less blood loss, shorter incision, and earlier ambulation. Emergency laparoscopic-assisted right hemicolectomy can be safely performed in patients with obstructing right-sided colonic carcinoma. If practiced more, it might be advocated as a bridge between the conventional open approach and traditional laparoscopic surgery.
authors.affiliation: Department of Gastrointestinal Surgery, First Affiliated Hospital, Nanchang University , Nanchang, Jiangxi Province, China .
authors.forename: Zhengrong
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, First Affiliated Hospital, Nanchang University , Nanchang, Jiangxi Province, China .
authors.forename: Daojiang
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, First Affiliated Hospital, Nanchang University , Nanchang, Jiangxi Province, China .
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Jie
authors.affiliation: Department of Gastrointestinal Surgery, First Affiliated Hospital, Nanchang University , Nanchang, Jiangxi Province, China .
authors.forename: Guoyang
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, First Affiliated Hospital, Nanchang University , Nanchang, Jiangxi Province, China .
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002277:Carcinoma / Q000150:complications / Q000601:surgery*; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D044682:Colon, Ascending / Q000601:surgery; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D005260:Female; D058733:Hand-Assisted Laparoscopy / Q000009:adverse effects; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D016138:Walking