[Laparoscopic versus open right hemicolectomy: 5-year oncology results]

Laparoscopic right hemicolectomy has developed less markedly than rectosigmoid resection, probably because of the more complicated regional anatomy and greater difficulty in performing an adequate regional lymphectomy. The aim of the present study was to analyse our 5-year experience with laparoscopic right hemicolectomy. Twenty patients were enrolled with non-metastatic, non-infiltrating right colonic cancer, treated laparoscopically and compared to a group well matched for age, sex, comorbidity and stage of disease, treated laparotomically. The duration of the laparoscopic procedures was slightly longer, but intraoperative blood loss, passage of flatus and hospital stay were reduced compared to the laparotomic procedure. Morbidity was similar and there was no 30-day mortality in either group. Specimen length and number of harvested lymph nodes were similar and the 5-year cumulative survival curves showed no statistically significant difference (72.5% versus 72.2%). Our experience shows that laparoscopic right hemicolectomy is a safe, effective and oncologically adequate procedure, comparable in all respects to open hemicolectomy, but with all the advantages of the minimally invasive technique. Yet, it remains a complex surgical procedure, requiring skill and a long learning curve. Further studies, possibly prospective and randomised, are necessary to define the exact role of this technique for the treatment of non-metastatic, non-infiltrating right colonic cancer.