Laparoscopic versus open complete meso-colic excision for right-sided colon cancer. Analysis of shortterm outcomes

Abstract

AIM: Laparoscopic complete mesocolic excision (CME) right hemicolectomy would show comparable short-term benefits as well as pathological and oncological outcomes to open surgery. The aim of this study was to compare laparoscopic and open CME technique for right-sided colon cancers in terms of pathology specimens and short-term results.

MATERIAL AND METODS: The data of patients who underwent laparoscopic CME (n=31) and open CME (n=35) for rightsided colon adenocarcinoma between January 2016 and June 2019 were analyzed retrospectively. Demographic data, preoperative, peroperative and postoperative parameters and pathology specimens of the two groups were compared.

RESULTS: There were no statistical differences between the laparoscopic CME group and the open CME group in terms of age, gender, body mass index, tumor location, American Society of Anesthesiologists (ASA) score, presence of comorbidities, history of other malignancy and previous abdominal surgery (p>0.05). Patients in the laparoscopic CME group had shorter incision lengths, longer operative times, less operative blood loss, shorter time to mobilization, early regain of bowel motion, shorter time to soft diet, reduced length of stay, and smaller tumor size (p<0.05). The mean number of harvested lymph nodes in laparoscopic and open CME groups was not statistically significant (29.83 ± 8.90 and 31.34 ± 13.10, respectively). There were no statistical differences in terms of length of the specimen between the laparoscopic and open CME groups (35.19 ± 9.8 cm and 32.71 ± 11.12 cm, respectively). The rate of 30-day postoperative complications was higher in the open CME group (35.5% vs. 42.9%, respectively), but not statistically significant (p>0.05).

CONCLUSIONS: Pathological (specimen lengths, resection margin lengths, number of lymph nodes, and R0 resection) and short-term outcomes of the laparoscopic CME group were comparable. Moreover, laparoscopic CME conferred short-term benefits in terms of shorter incision lengths, less operative blood loss, reduced time to mobilization, early regain of bowel motion, shorter time to soft diet, and reduced length of hospital stay. Based on these results, laparoscopic CME can be considered as a routine elective approach for right-sided colon cancer.