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Comparison of hand-assisted laparoscopic versus laparoscopic resection for right colon cancers in elderly patients

Mingtian Wei, MD, Wanbin He, MD, Yan Li, BD, Zongguang Zhou, Junhong Han, MD, Ziqiang Wang, MD. West China Hospital, Sichuan University

Background: In China, existing evidences have revealed an increasing proportion of patients aged 70 or over suffer from colorectal cancers. Little has been investigated on the comparison of hand-assisted laparoscopic surgery (HALS) and laparoscopic surgery (LS) in a specific population of elderly patients with right colon cancers.

Method: We retrospectively reviewed the patients aged 70 years or over who underwent right colon cancers in our institution between June, 2009 and December, 2014. Short- and long- terms outcomes including surgical endpoints, postoperative morbidity and mortality, overall survival (OS) and disease free survival (DFS) were compared between HALS and LS groups. All data was analyzed by SPSS 22.0.

Results: Finally, 45 consecutive patients (HALS= 18, LS= 27) with right colon cancers were included in the analysis. The baseline characteristics were comparable between groups. HALS experienced shorter operative time than LS (median: 135 min vs. 165 min, p< 0.05). On the same time, there were no significant difference between groups with regard to estimated blood loss (median: 34.35 ml vs 33.33 ml, p> 0.05), anus exhaust (median: 91.64 h vs 93.47 h, p> 0.05), oxygen Inhalation (median: 34.80 h vs 35.37 h, p> 0.05), gastric tube retaining time (median: 30.86 h vs 35.48 h, p> 0.05), and postoperative hospital time (median: 7.00 days vs 8.43 days, p> 0.05). However, more complications were observed in LS group (25.93%, 7/27) than HALS group (16.67%, 3/18). There were no postoperative mortalities in both HALS and LS groups. As for cancer-specific survival, patients with HALS acquired significant decreased 3-year OS than LS (83.3% vs 96.3%, p= 0.001), with comparable 3-year DFS (77.8% vs 81.5%, p= 0.061).

Conclusion: HALS is more effective than LS for treatment of right colon cancers in terms of surgical time and postoperative morbidity, however, cancer-specific survival in HALS is worse than LS.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79952

Program Number: P264

Presentation Session: Poster (Non CME)

Presentation Type: Poster

44

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