Comparison of post-operative outcomes in laparoscopic and open right colectomy for colon cancer: A 4-year single centre experience
pdf

Keywords

colon cancer
oncology
colectomy
laparoscopic surgery

Abstract

Background: Laparoscopic right colectomy (LRHC) is a procedure which has been getting more popular compared to traditional open right colectomy (ORHC) over the last three decades. This study compares the post-operative outcomes in laparoscopic and open right colectomy for colon cancer.

Patients and Methods: This is a retrospective study of right colectomy at a single institution from January 2018 to December 2021. The factors that were studied included postoperative HDU admission, the incidence of post-operative ileus (POI) and the length of hospital stay.

Results: During the study period, 161 patients underwent right hemicolectomy. Sixty-seven (42%) underwent LRHC, 73 (45%) ORHC, and 21 (13%) laparoscopic converted to open procedure. The overall incidence of POI was 56 (35%), 14 (21%) among the LRHC and 28 (38%) among the ORHC group (p=0.024). The length of hospital stay was 7.1 (±4.8) days after the laparoscopic procedure compared to 8.7 (±4.4) in the open group (p=0.048). Forty-two patients out of 161 (26%) needed post-operative HDU admissions; out of these 11 (16%) were in the laparoscopic group and 29 (40%) among the open group (p=0.023).

Conclusion: Post-operative recovery was significantly quicker among the laparoscopic right hemicolectomy group incomparison to the open right hemicolectomy group.

https://doi.org/10.48037/mbmj.v9i5.1418
pdf

References

Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991;1(3):144-150.

Künzli BM, Friess H, Shrikhande SV. Is laparoscopic colorectal cancer surgery equal to open surgery? An evidence based perspective. World J Gastrointest Surg 2010;2(4):101-108. Available from: https://doi.org/10.4240/wjgs.v2.i4.101

Chung CC, Ha JP, Tsang WW, Li MK. Laparoscopic-assisted total mesorectal excision and colonic J pouch reconstruction in the treatment of rectal cancer. Surg Endosc. 2001;15(10):1098-1101. Available from: https://doi.org/10.1007/s00464-001-9000-2

Yamamoto S, Watanabe M, Hasegawa H, Kitajima M. Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. Dis Colon Rectum. 2002;45(12):1648-1654. Available from: https://doi.org/10.1007/s10350-004-7253-2

Morino M, Parini U, Giraudo G, et al. Laparoscopic total mesorectal excision: a consecutive series of 100 patients. Ann Surg. 2003;237(3):335–342. Available from: https://doi.org/10.1097/01.SLA.0000055270.48242.D2

Benz S, Tam Y, Tannapfel A, Stricker I. The uncinate process first approach: a novel technique for laparoscopic right hemicolectomy with complete mesocolic excision. Surg Endosc. 2016;30(5):1930–7. Available from: https://doi.org/10.1007/s00464-015-4417-1

Haas EM, Pedraza R, Nieto J, Malave V. Single-incision laparoscopic right hemicolectomy: inferior-to-superior approach with intracorporeal anastomosis. Surg Laparosc Endosc Percutan Tech. 2014;24(6):e226–7. Available from: https://doi.org/10.1097/SLE.0b013e3182937bf6

Krouchev R, Tamana S, Nguyen N, Yorke E, Harris D, Sampath S. Total intracorporeal anastomosis for right hemicolectomy: experience from a Canadian center. Am J Surg. 2018;215(5):905–8. Available from: https://doi.org/10.1016/j.amjsurg.2018.02.013

Tong DK, Law WL. Laparoscopic versus open right hemicolectomy for carcinoma of the colon. JSLS. 2007;11(1):76-80.

Di Lascia A, Tartaglia N, Petruzzelli F, et al. Right hemicolectomy: laparoscopic versus robotic approach. Ann Ital Chir 2020;91:478-485.

Stavrou E, Tzanakis N, Spartalis E, et al. Comparison of post-operative and oncologic outcomes in laparoscopic and open right colectomy for colon cancer: a 5-year experience. In Vivo. 2022;36(2):969-972. Available from: https://doi.org/10.21873/invivo.12788

Wind J, Polle SW, Fung Kon Jin PH, et al. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg 2006;93(7):800-9. Available from: https://doi.org/10.1002/bjs.5384

Sammour T, Zargar-Shoshtari K, Bhat A, et al. A program of Enhanced Recovery After Surgery (ERAS) is a cost-effective intervention in elective colonic surgery. NZMJ. 2010;123(1319):61-70.

Gouvas N, Tan E, Windsor A, et al. Fast-track vs standard care in colorectal surgery: A meta-analysis update. Int J Colorectal Dis 2009;24(10):1119-31. Available from: https://doi.org/10.1007/s00384-009-0703-5

Tjandra JJ, Chan MK. Systematic review on the short-term outcome of laparoscopic resection for colon and rectosigmoid cancer. Colorectal Dis 2006;8(5):375. Available from: https://doi.org/10.1111/j.1463-1318.2006.00974.x

Young-Fadok TM, Fanelli RD, Price RR, et al. Laparoscopic resection of curable colon and rectal cancer: An evidence-based review. Surg Endosc 2007;21(7):1063. Available from: https://doi.org/10.1007/s00464-006-9172-x

Veldkamp R, Kuhry E, Hop WCJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84. Available from: https://doi.org/10.1016/S1470-2045(05)70221-7

Nelson H, Sargent DJ, Wieand HS, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–9. Available from: https://doi.org/10.1056/NEJMoa032651

Bauer AJ, Boeckxstaens GE. Mechanisms of postoperative ileus. Neurogastroenterol Motil. 2004;16(Suppl 2):54–60. Available from: https://doi.org/10.1111/j.1743-3150.2004.00558.x

Tan WS, Chew MH, Ooi BS, et al. Laparoscopic versus open right hemicolectomy: a comparison of short-term outcomes. Int J Colorectal Dis. 2009;24(11):1333-9. Available from: https://doi.org/10.1007/s00384-009-0743-x

Matsuda T, Endo H, Inomata M, et al. Clinical outcome of laparoscopic vs open right hemicolectomy for colon cancer: A propensity score matching analysis of the Japanese National Clinical Database. Ann Gastroenterol Surg. 2020;4(6):693-700. Available from: https://doi.org/10.1002/ags3.12381

Neyens R, Jackson KC 2nd. Novel opioid antagonists for opioid induced bowel dysfunction and postoperative ileus. J Pain Palliat Care Pharmacother. 2007;21(2):27-33.

Khan JS, Hemandas AK, Flashman KG, Senapati A, O’Leary D, Parvaiz A. Clinical outcome of laparoscopic and open colectomy for right colonic carcinoma. Ann R Coll Surg Engl. 2011;93(8):603-7. Available from: https://doi.org/10.1308/147870811X13137608455299

Lee CZ, Kao LT, Lin HC, Wei PL. Comparison of clinical outcome between laparoscopic and open right hemicolectomy: a nationwide study. World J Surg Oncol. 2015;13:250. Available from: https://doi.org/10.1186/s12957-015-0666-7

Chaouch MA, Dougaz MW, Mesbehi M, et al. A meta-analysis comparing hand-assisted laparoscopic right hemicolectomy and open right hemicolectomy for right-sided colon cancer. World J Surg Oncol.2020;18(1):91. Available from: https://doi.org/10.1186/s12957-020-01869-w