[Right hemicolectomy for colon cancer: a prospective randomised study comparing laparoscopic vs. open technique]

Chir Ital. Jan-Feb 2008;60(1):1-7.
[Article in Italian]


Since 2001 we have conducted a prospective randomised study of right laparoscopic-assisted hemicolectomy vs open right hemicolectomy for right colon cancer in order to assess the differences in intraoperative and postoperative results as well as oncological clearance. Thirty-three patients with right colon cancer received laparoscopic-assisted right hemicolectomy (LRH) and were compared with 33 patients who underwent open right hemicolectomy (ORH). We analysed morbidity and mortality, number of postoperative days of starving, postoperative days tolerating a liquid diet and a soft diet, duration of postoperative ileus, as well as the distance of the resection margin from the tumour (< 5 cm or >5 cm), and the number of lymph nodes found in the resected specimen. We also compared the length of operative time, blood loss, and any associated surgery. Morbidity occurred in 1 patient undergoing LRH (3.0%) as against 4 patients (12.1%) in the ORH group (p < 0.05). Postoperative ileus lasted 3.15 days (range: 3-5 days) in the LRH group vs 3.0 days (range: 1-4 days) in the ORH group. Median operative time was 251 min (range: 130-360 min) in the LRH group vs 222.9 min (range: 135-360 min) in the ORH group, while blood loss amounted to a median of 135 mi (range: 100-300 ml; SD +/- 42.9 mi) in the LRH group vs. 404.1 ml (range: 250-1000 ml; SD +/- 159.3 ml) in the ORH group (p <0.05). The distance of the resection margin from the tumour was more than 5 cm in both groups. In the LRH group a median of 12.7 lymph nodes were removed (range: 9-31; SD +/- 4.5) vs. 18 lymph nodes in the ORH group (range: 8-29; SD +/- 3.9) (p < 0.05). Associated surgery was performed in 15.1% of cases in both groups. In our experience LRH presents a statistically significant advantage in terms of morbidity and blood loss compared to ORH. Equivalent oncological clearance was obtained, fulfilling the stated criteria of 5 cm free resection margins and number of lymph nodes resected, though we removed fewer lymph nodes in LRH compared to ORH (p < 0.05).

Publication types

  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical
  • Colectomy / methods*
  • Colectomy / rehabilitation
  • Colectomy / statistics & numerical data
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Female
  • Hospital Mortality
  • Humans
  • Ileus / epidemiology
  • Ileus / etiology
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Laparotomy / methods*
  • Laparotomy / rehabilitation
  • Laparotomy / statistics & numerical data
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Postoperative Care
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prospective Studies