Laparoscopic versus Open Right Hemicolectomy : A single centre experience

M A Gok, S J Ward, M M Sadat, U A Khan. Macclesfield District General Hospital

Intoduction Colorectal cancer is the 3rd most commonest maligancy in men & woemn in the UK. representing 13% of all new cancers in 2010. Right sided cancers (appendic, caecum, ascending & transverse colon) contribute to a 3rd of colorectal maligancies. The aim of the study is to assess right hemicoloectomies carried out at a district general hospital.

Materials & Methods This is a retospective study carried out since 2008 at Macclesfiedl District Genereal Hospital. Descriptive demography, co-morbidities,histopathology & surgical outcomes were evaluated for all right hemicolectomies (laparoscopic, open & emergency cases).

Discussion Laparoscopic Rt Hemi has advantage of minimal invasion, earlier recovery, lowere rates of wound complications, shorter hospital stay & comparable survival rates of Open Rt Hemi. The prolonged operative time is attributed to the use of laparoscopy. Em Rt Hemi had a poorer survival as patients were generally ill (ASA 3) with sepsis.

Lap Rt Hemi (n=93)Open Rt Hemi (n=118)Em Rt Hemi (n =75)Kruskal-Wallis test (p value)
Age (yrs)74.872.370.0NS
Sex (M : F)41 : 5267 : 5133 : 42NS
ASA223< 0.05
Weight (kg)67.680.468.6< 0.05
BMI24.527.025.0< 0.05
Ascending colon222312
Transverse colon193330
Op time (min)145.8107.1118.6< 0.05
LN harvest (n)1616.514NS
Diverticulosis (n)141413NS
Synchronous tumours (n)10319< 0.05
LOS (days)7911< 0.05
small bowel length (mm)92.292.7124.1< 0.05
large bowel length (mm)218.5231.8309.5NS
1st year survival95.190.573.7logrank p < 0.05
3rd year survival82.276.549.9logrank p < 0.05
5th year survival69.471.745.4logrank p < 0.05

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