Comparison of laparoscopic versus open complete mesocolic excision for right colon cancer

Abstract

Aim: To explore the feasibility, safety, efficacy, and short-term oncologic outcomes of laparoscopic-assisted complete mesocolic excision (CME) for right colon cancer.

Methods: The clinical data from 102 patients with right colon cancer who underwent laparoscopic CME (n = 53; LS group) and open CME (n = 49; OS group) from June 2012 to December 2013 were retrospectively reviewed. Outcomes of the two groups were compared.

Results: There were no conversions to open surgery in the LS group. The operative time in the LS group was similar to that in the OS group (194 ± 57 vs. 177 ± 51 min, respectively, p = 0.118). Intraoperative blood loss was significantly less in the LS group compared with the OS group (94 ± 56 vs. 118 ± 60 ml, respectively, p = 0.039). There was no difference in the total number of harvested lymph nodes (14 ± 6 vs. 13 ± 5, respectively, p = 0.313). The time to resume liquid diet (3 ± 2 vs. 5 ± 2 d, p < 0.001) and length of hospital stay (11 ± 4 vs. 14 ± 6 d, p = 0.002) were significantly shorter in the LS group. The rate of complications was similar between the groups (4% vs. 12%, respectively, p = 0.222). No recurrences were noted in either group during follow-up (range, 6-24 months).

Conclusion: Laparoscopic CME is a safe, feasible, and effective minimally invasive procedure for right colon cancer.

Keywords: Complete mesocolic excision; Laparoscopy; Laparotomy; Right hemicolectomy.