Right colectomy for cancer: validity of laparoscopic approach

Abstract

Aim: Laparoscopic assisted right colectomy for carcinoma is a procedure with demonstrated feasibility. We want to evaluate the advantages.

Material: In the period 1999/2002 we have executed 7 laparoscopic right colectomy for carcinoma. We have compared the results with one group of 10 patients traditionally operated in the period 1998/2002. In both groups the oncologic staging was almost the same.

Results: Immediate results: operative time was 240’ for laparoscopy vs. 150’ for open operation; no anastomotic dehiscence for laparoscopy vs. 1/10 for open; no bronchopulmonary-thrombotic complications for laparoscopy vs. 2/10 for open, but there was 1/7 wound infection for laparoscopy vs. 1/10 for open; the return to the mobilization and normal diet was 3 days for laparoscopy vs. 7 days for open; the postoperative stay was 7 days for laparoscopy vs. 12 days for open.

Discussion: The two procedures did not condition differences neither in the extension of the resection and of the lymphectomy nor a different incidence of the anastomosis dehiscences. Differences were noted, in the operative time, in a more precocious mobilization with a minor use of analgesics, in a more rapid renewal of peristalsis and of feeding with a lower postoperative stay. These advantages are remarkable in our study, by reducing the postoperative morbidity. The very brief follow-up of almost 6 months, did not show a relapse of the disease in patients of both series.

Conclusion: In our experience, laparoscopic-assisted right colectomy confirmed evident advantages in the immediate postoperative period for the treatment of the colonic cancer.