Laparoscopic right hemicolectomy for cancer: 11-year experience

Laparoscopic surgery has emerged as the gold standard for many intra-abdominal procedures. Laparoscopic colon surgery is now entering its second decade of practice, and although there are many papers focusing on surgery of the distal colon, only a few have been published regarding right sided lesion approached totally laparoscopically.

Present data collected-in a prospective manner from a single institute over an eleven year period, focusing on laparoscopic right hemicolectomy for malignancy.

Patients elected for laparoscopic right hemicolectomy for colon cancer were analyzed prospectively. From May 1991 to May 2002, 98 patients underwent attempted laparoscopic right hemicolectomy for cancer, 44 male and 54 female, with a mean age of 70.6 years, emergent and non emergent cases were included Patients who underwent a diagnostic laparoscopy and those converted immediately to open procedure were excluded from this study.

Ninety-two patients were included in the study, eighty-two of these had a totally intracorporeal anastomosis created, and ten had an extracorporeal anastomosis performed. The mean operative time for the intracorporeal group was 136 minutes, and for the extracorporeal group was 159 minutes. The average number of lymph nodes harvested was 10.8 and the final pathologic analysis showed 26 tumors stage I, 24 stage II, 31 stage III and 17 stage IV.

In experienced hands, laparoscopic colectomy can be performed safely and effectively for the treatment of both benign and malignant diseases of the right colon. This study reaffirms the contention that laparoscopic approach to colon cancer offers equivalent, or in some instances, greater oncologic safety when compared to the open technique.