Laparoscopic versus open right hemicolectomy for carcinoma of the colon.

ABSTRACT

OBJECTIVE: This study aimed to compare the outcomes of laparoscopic resection (LR) with open resection (OR) for right-sided colon cancer. METHODS: During the study period from June 2000 to December 2004, 182 patients (84 men) underwent elective resection for cancer of the right colon. Laparoscopic resection was performed in 77 patients, while 105 patients had open operations. Patients who underwent operations on an emergency basis were excluded. Data on the patients' demographics, operative details, and postoperative complications were collected prospectively. The outcomes of patients with laparoscopic resection were compared with those of patients with open surgery. RESULTS: There was no difference in the age, sex, presence of premorbid medical conditions, and blood loss between the 2 groups. The mean operative time for open resection was 115.4 minutes and that for laparoscopic resection was 165.1 minutes (P<0.001). Among the 77 patients who underwent laparoscopic resection, 7 (9%) required conversion to an open operation. There was no difference in postoperative surgically related complications including wound infection, leakage, intestinal obstruction, postoperative ileus. Nonsurgical-related complications were also similar. The median time to resumption of a normal diet was 3 days and 4 days in the laparoscopic and open groups, respectively. The median hospital stay in patients with laparoscopic resection was significantly shorter than in patients with open surgery (6.0 days vs 7.0 days, P<0.001). The 2-year overall survival rates were 74% in both groups (P=0.904). In the converted to open (LCOR) group, the hospital stay was significantly longer (LR vs OR vs LCOR, 5.5 days vs 7.0 days vs 9.0 days respectively, P<0.001). CONCLUSION: Laparoscopic right hemicolectomy is a safe option for cancers of the right colon. It is associated with a shorter hospital stay and earlier resumption of a normal diet. Mortality and morbidity are similar to that with the open approach. There is no compromise in the survival of patients.