Reduced port versus open right hemicolectomy for colorectal cancer: a retrospective comparison study of two centers

Int J Colorectal Dis. 2021 Jul;36(7):1469-1477. doi: 10.1007/s00384-021-03923-9. Epub 2021 Apr 6.

Abstract

Purpose: The concept of complete mesocolic excision (CME) in right-sided colorectal cancer is well known for open and laparoscopic surgery. The aim of this study was to evaluate and compare perioperative and oncological outcomes of reduced port and open surgery for right-sided colorectal cancer.

Methods: One hundred forty-one patients received elective surgery for right-sided colonic cancer between January 2015 and December 2019 and were included in a retrospective database.

Results: We observed longer operation time in the RP-CME group (145 min vs. 119.43 min, p<0.01). Hospital stay (8 days vs. 14 days, p<0.01) and time to first intestinal passage (42 h. vs. 59 h, p<0.01) were significantly shorter in the reduced port group. Postoperative complications were more likely to be observed in the O-CME group (7.2% vs. 14.1%, p=0.28); anastomotic leakage rate was low in both groups (1.8% vs. 2.4%, p=1.00). Specimen scores (score 1= good: 93.8% vs. 91.7%, p=1.00) and average number of retrieved lymph nodes were comparable (24 vs. 23 p=0.69). In O-CME patients, we observed more advanced tumor stages (UICC III: 21.4% vs. 45.9%, p<0.01).

Conclusion: To our knowledge, this is the first study comparing reduced port to open surgery for right-sided colorectal cancer. We could demonstrate that this technique is feasible for oncological right hemicolectomy with observation of shorter hospital stay and lower morbidity rates compared to open surgery. The oncological outcome did not differ in the present study.

Keywords: Colorectal cancer; Complete mesocolic excision; Open surgery; Reduced port laparoscopic surgery; Right hemicolectomy.

MeSH terms

  • Colectomy
  • Colonic Neoplasms* / surgery
  • Humans
  • Laparoscopy*
  • Lymph Node Excision
  • Mesocolon* / surgery
  • Operative Time
  • Retrospective Studies
  • Treatment Outcome