Total laparoscopic approach for the treatment of right colon cancer: A technical critique

Abstract

Background and aims: Total laparoscopic surgery is not a new concept, but it is not preferred generally for right colectomy. The aim of the study is to evaluate the outcomes, which are related with surgical technique after total laparoscopic right colectomy (TLRC) and laparoscopic-assisted right colectomy (LARC) for right colon cancer in 30 consecutive patients. Materials and methods: Thirty patients with right colon cancer, half of which were treated with TLRC and half of which were treated with LARC, were compared with regard to patient demographics, operative and postoperative data, histopathologic findings, follow-up data, and the complications related to the surgical technique. Results: There were 16 men and 14 women, median age was 63 years (range 41–86) with a body mass index (BMI) of 27 kg/m2 (range 20–33). There were no differences between the groups for BMI, harvested lymph node number, or distal and radial margins. The length of the incision and the length of the postoperative stay was shorter in the TLRC group (p = 0.000). Overall complications were higher in the LARC group than in the TLRC group (p = 0.014). The median follow-up was 28 months (range 5–99). In the late period, two patients in the LARC group were reoperated on. The cause of reoperation was internal herniation in one patient due to ileal twisting and incisional hernia in the other one. Conclusion: Our preliminary data indicate that TLRC could result in better outcomes for right colon cancer patients than LARC.

Keywords

• extracorporeal anastomosis
• intracorporeal anastomosis
• laparoscopic right colectomy
• total laparoscopic colon resection