Laparoskopisk versus åben höjresidig hemikolektomi til behandling af koloncancer
Sammanfattning
INTRODUCTION: In Denmark, we are still debating whether a laparoscopic approach is beneficial for patients scheduled for right-sided hemicolectomy. The aim of this study was to compare the outcome of laparoscopic versus open resection for right-sided colon cancer. MATERIAL AND METHODS: Using the Danish Colorectal Cancer Group (DCCG) database, we identified two groups each with 42 patients who underwent either laparoscopic right hemicolectomy (LRH) or open right hemicolectomy (ORH). The two groups were compared with respect to demographic data, length of hospital stay, number of glands harvested, blood loss, surgical complications and mortality. RESULTS: The length of hospital stay was significantly shorter in the LRH group than in the ORH group (five vs. six, p = 0.023). Furthermore, the number of lymph nodes harvested was significantly larger in the LRH group than in the ORH group (23 vs. 15, p < 0.001). We found fewer anastomotic leaks (three vs. five), fewer patients with postoperative complications including anastomotic leaks (eight vs. 14) and lower operation-related mortality (zero vs. three). None of these differences were statistically significant. CONCLUSION: LRH is comparable to ORH with regards to morbidity, mortality and blood loss. Furthermore, LRH is associated with a shorter hospital stay and a higher radical lymph node harvest than ORH. The results and the thesis that LRH will result in fewer hernias and better cosmetic outcomes makes LRH a promising surgical procedure.