Background and Objectives: Laparoscopic procedures have become a routine approach in colorectal surgery. We aimed to evaluate intraoperative, postoperative and pathological outcomes of laparoscopic right hemicolectomy in comparison with open right hemicolectomy. Materials and Methods: We reviewed our database for colorectal surgery and collected data regarding right hemicolectomies performed over a period of 10 years regarding patient characteristics, operative outcomes and postoperative outcomes. We compared laparoscopic with open right hemicolectomies. All the anastomoses in the laparoscopic group were performed intracorporeally. Results: We included 384 cases, 74 (19.3%) laparoscopic and 310 (80.7%) open right hemicolectomies. Baseline characteristics were comparable between the two groups. Conversion rate was low (2.7%). A drain was placed more often in the open colectomies (p < 0.001). Laparoscopic colectomies lasted longer by 25 min on average in the entire cohort (p = 0.002) and by 30 min in cancer-only cases without concomitant procedures (p < 0.001). Laparoscopic procedures yielded more lymph nodes (p = 0.007), as well as longer distal resection margins (p < 0.001) and total specimen (p < 0.001). There was no difference between the two approaches concerning intraoperative complications (p = 0.36) or need for transfusion (p = 0.708). There was also no difference regarding overall (p = 0.361) or major complications (p = 1), as well as anastomotic leak (p = 0.475), surgical site infections (p = 0.275) or readmission rates (p = 1). Hospitalisation duration was shorter by 3 days after laparoscopic surgery in the entire cohort (p < 0.001), as well as when cancer-only cases without concomitant procedures were considered (p < 0.001). Conclusions: Laparoscopic right hemicolectomy with intracorporeal anastomosis provides perioperative safety and pathology outcomes comparable to open surgery, while significantly reducing hospital stay.
Garantzioti et al. (Sun,) studied this question.