Short-Term Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: With a Propensity Score Matching Analysis

J Invest Surg. 2020 Oct;33(9):822-827. doi: 10.1080/08941939.2019.1579276. Epub 2019 Apr 4.

Abstract

Purpose: The aim of this study is to compare the short-term and pathological outcomes of TPLRC (Three-port laparoscopic right hemicolectomy) and FPLRC (Five-port laparoscopic right hemicolectomy), using propensity score matching analysis. Methods: One hundred and sixty-eight patients who accepted laparoscopic right hemicolectomy with either three ports or five ports from January 2013 to October 2017 were non-randomly selected and analyzed retrospectively. Propensity score matching model was used to eliminate the patients' selection bias between two groups. Results: A total of 168 patients were involved. After propensity score matching, 39 for each group were compared. The number of harvested lymph nodes was significantly larger in the TPLRC group than in the FPLRC group (18.36 ± 8.58 vs. 14.90 ± 6.63, p = 0.048). A lower mean operative time was observed in the TPLRC group (136.24 ± 26.78 vs. 168.64 ± 43.68 min, p < 0.001). A less blood loss in the TPLRC group (62.44 ± 55.17, 135.54 ± 139.11 ml, p = 0.003). No significant differences in the other short-term outcomes between the two groups. Conclusions: TPLRC is a safe and feasible surgical procedure with similar results of FPLRC in short-term clinical outcomes. TPLRC has the advantages of shorter operative time, less blood loss and larger number of harvested lymph nodes. A randomized prospective clinical trial of long-term outcomes of TPLRC is required to further prove the present results.

Keywords: colon cancer; laparoscopic surgery; right hemicolectomy; three ports.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Loss, Surgical / statistics & numerical data
  • Colectomy / adverse effects
  • Colectomy / instrumentation
  • Colectomy / methods*
  • Colorectal Neoplasms / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / instrumentation
  • Laparoscopy / methods*
  • Lymph Node Excision / statistics & numerical data
  • Lymph Nodes / surgery
  • Male
  • Middle Aged
  • Operative Time
  • Propensity Score
  • Retrospective Studies
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / prevention & control
  • Treatment Outcome