Three-Port Laparoscopic Right Colectomy Versus Conventional Five-Port Laparoscopy for Right-Sided Colon Cancer

J Laparoendosc Adv Surg Tech A. 2019 Apr;29(4):465-470. doi: 10.1089/lap.2018.0498. Epub 2018 Nov 8.

Abstract

Background: The purpose of the study was to evaluate the safety and effectiveness of three-port laparoscopic right colectomy (3-LRC) for right-sided colon cancer compared with conventional five-port laparoscopic right colectomy (5-LRC).

Materials and methods: One hundred sixty-three patients diagnosed with right-sided colon adenocarcinoma underwent laparoscopic right colectomy (LRC) between April 2011 and December 2017. Seventy-four of these patients underwent 3-LRC procedure and 89 patients underwent 5-LRC. Clinical characteristics, perioperative short-term outcomes, and pathologic data were analyzed.

Results: There were no differences in TNM stage, tumor location, estimated blood loss, complications, and open conversion rates. The operation time was shorter in the 3-LRC group than in 5-LRC group (140.9 ± 27.5 minutes versus 178.2 ± 38.2 minutes; P = .001). The number of harvested lymph nodes (28.5 ± 13.9 versus 22.6 ± 11.7; P = .004) was also higher in the 3-LRC group. The first passage of flatus and first oral diet were significantly faster in the 3-LRC group than in the 5-LRC group (2.8 ± 1.0 days versus 4.0 ± 1.2 days; P = .001, 3.6 ± 2.9 days versus 5.0 ± 1.5 days; P = .001). The number of patients who required analgesics is less in the 3-LRC group (32.4% versus 43.8%; P = .583).

Conclusion: 3-LRC for right-sided colon cancer is technically feasible and is associated with a short operation time. We believe that 3-LRC effectively reduces the costs associated with equipment and manpower and represents a standard procedure.

Keywords: colon cancer; laparoscopy; reduced port; right colectomy; three ports.

Publication types

  • Multicenter Study

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / surgery*
  • Aged
  • Colectomy / methods*
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / surgery*
  • Equipment Design
  • Female
  • Humans
  • Laparoscopes*
  • Laparoscopy / methods*
  • Male
  • Neoplasm Staging
  • Operative Time
  • Treatment Outcome