Laparoscopic versus open transverse-incision right hemicolectomy: a retrospective comparison study

Background: The optimal surgical approach to right colon cancer is still under debate. The aim of the present study was to compare the short- and long-term outcomes of lapa-roscopic and transverse-incision open approaches to right hemicolectomy for colon can-cer. Methods: Data on 99 adult patients with right side colon cancer undergoing either laparo-scopic or open transverse-incision right hemicolectomy at two different university hospi-tals, between January 2013 and December 2016, were retrospectively reviewed. Data con-cerning patients’ characteristics, operative details, functional recovery, and postoperative length of hospital stay were retrieved from prospective databases and analyzed. Results: Forty-nine subjects were operated on laparoscopically while 50 through an open transverse incision. Operating time was significantly longer in the laparoscopic group compared with the open group (182 vs. 105 min; p<0.01). Patients treated laparoscopically had a shorter time to first bowel movement, while time to resume a normal diet and post-operative length of hospital stay were comparable in between groups. The median number of lymph nodes harvested was higher in the laparoscopic group (25.6 vs. 18.6; p<0.01), but no significant difference in overall survival between groups was detected. At long term follow up, the incidence of incisional hernia was higher in the laparoscopic group as com-pared to the open group (24.5% vs. 0%; p=0.0002). Conclusion: Our results show that laparoscopic right hemicolectomy when compared to the transverse-incision open procedure may guarantee the same oncological radicality, but short-term functional benefits are still unclear. Randomized control studies are warranted to better clarify the comparison of these two approaches for right-sided colon cancers.