Emergency Laparoscopic-assisted versus Open Right Hemicolectomy for Obstructing Right-sided Colonic Carcinoma: A Comparative Study of Short-term Clinical Outcomes

• Published in: World journal of surgery 2008-03, Vol.32 (3), p.454-458
• Main Authors: Ng, Simon S. M., Lee, Janet F. Y., Yiu, Raymond Y. C., Li, Jimmy C. M., Leung, Wing Wa, Leung, Ka Lau
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Aged; Biological and medical sciences; Carcinoma - complications; Carcinoma - surgery; Cardiac Surgery; Clinical outcomes; Colectomy - methods; Colonic Neoplasms - complications; Colonic Neoplasms - surgery; Colorectal Stents; Digestive system. Abdomen; Dilate Bowel Loop; Early Ambulation; Emergency Medical Services; Endoscopy; Female; General aspects; General Surgery; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Investigative techniques, diagnostic techniques (general aspects); Laparoscopic Colorectal Resection; Laparoscopy; Lower Morbidity Rate; Male; Medical sciences; Medicine; Medicine & Public Health; Surgery; Thoracic Surgery; Time Factors; Treatment Outcome; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-007-9400-0

Background The aim of the present study was to compare the clinical outcomes of emergency laparoscopic-assisted versus open right hemicolectomy for obstructing right-sided colonic carcinoma. Methods Between July 2003 and July 2006, 43 consecutive patients with obstructing right-sided colonic carcinoma underwent emergency right hemicolectomy at our institution, 14 with the laparoscopic-assisted approach and 29 with the open approach. Clinical data were retrospectively recorded and compared between the two groups. Results There were no significant differences between the two groups with respect to age, gender, co-morbidities, duration of obstructing symptoms, tumor length, and tumor staging. The laparoscopic-assisted group had longer operative time than the open group (187.5 min versus 145 min; p  = 0.034) but less blood loss (20 ml versus 100 ml; p  = 0.020). The median time to full ambulation was significantly shorter in the laparoscopic-assisted group (4 days versus 6 days; p  = 0.016), but the time to return of gastrointestinal function and the duration of hospital stay were similar between the two groups. More patients in the open group developed postoperative complications (55.2% versus 28.6%), but the difference was not statistically significant. Conclusions Emergency laparoscopic-assisted right hemicolectomy for obstructing right-sided colonic carcinoma is feasible and safe. In comparison with the open approach, the laparoscopic-assisted procedure is associated with less blood loss, earlier ambulation, and possibly lower morbidity rate.