A comparison of short-term outcome after laparoscopic, transverse, and midline right-sided colectomy

作者：Tanis E; van Geloven A A W^*; Bemelman W A; Wind J

来源：International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery, 2012, 27(6): 797-802.

DOI：10.1007/s00384-011-1404-4

• Hemicolectomy
• Right-sided colectomy
• Laparoscopy
• Transverse incision
• Midline laparotomy
• Morbidity and short-term outcome

The aim of the present study was to compare the laparoscopy, transverse, and midline laparotomy in right-sided colectomies with respect to short- and long-term outcome. %26lt;br%26gt;The short- and long-term results of all patients who had an elective right-sided hemicolectomy, from January 2006 to April 2009 for malignant or benign disease, were evaluated according to the surgical technique: laparoscopic, midline, or transverse incision laparotomy. %26lt;br%26gt;The 75 included patients (41% male) had laparoscopy (n = 30), midline (n = 22), or transverse incision laparotomy (n = 23). Median operating time in the laparoscopy group was significantly longer in comparison to the midline and transverse incision groups (129, 105, and 101 min respectively, p %26lt; 0.001). Short-term follow-up revealed a longer median total length of stay in the midline laparotomy group compared to the other groups (9 vs. 7 days, p = 0.026). Thirty-day morbidity was less in the laparoscopy and transverse incision groups compared to the midline laparotomy group (15%, 20%, and 41%; p = 0.06). After excluding patients who had a previous midline incision, an earlier return of bowel function was seen for laparoscopy and transverse hemicolectomy (3 vs. 5 days, p = 0.017). At a median follow-up of 40 months (21-58), four incisional hernias occurred, two in the midline laparotomy group (one operatively corrected) and two in the laparoscopy group. %26lt;br%26gt;Although the results of this study need to be interpreted with care, our study shows that laparoscopic and transverse right hemicolectomy are equivalent and have a significant better short-term outcome compared to an open midline approach. In particular, laparoscopy and transverse laparotomy result in %26gt; 50% reduction in 30-day morbidity, no reoperations, and a shorter median total hospital stay of 2 days.

• 出版日期2012-6