Research Report
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World J Gastroenterol. Jun 28, 2014; 20(24): 7926-7932
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7926
Laparoscopic vs open extended right hemicolectomy for colon cancer
Li-Ying Zhao, Pan Chi, Wei-Xing Ding, Shun-Rong Huang, Si-Fen Zhang, Kai Pan, Yan-Feng Hu, Hao Liu, Guo-Xin Li
Li-Ying Zhao, Yan-Feng Hu, Hao Liu, Guo-Xin Li, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Pan Chi, Department of General Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian Province, China
Wei-Xing Ding, Department of Gastrointestinal Surgery, The First Peoples Hospital of Foshan, Foshan 528000, Guangdong Province, China
Wei-Xing Ding, Department of Gastrointestinal Surgery, the Tenth Hospital of Tongji University, Shanghai 200072, China
Shun-Rong Huang, Department of General Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Si-Fen Zhang, Rectal Disease Center of the 2nd affiliated Medical College of Guangzhou Traditional Chinese Medico-pharmaceutical University, Guangzhou 510120, Guangdong Province, China
Kai Pan, Department of Gastrointestinal Surgery, Shenzhen Peoples Hospital, The Second Affiliated Hospital of Jinan University, Shenzhen 51802, Guangdong Province, China
Author contributions: Zhao LY and Chi P contributed equally to this work in the design and preparation of this study and should both be considered as co-first authors; Chi P, Ding WX, Huang SR, Zhang SF, Pan K and Li GX performed the surgeries; Zhao LY, Liu H and Hu YF collected and analyzed the data; Zhao LY, Hu YF, Liu H and Li GX wrote the paper.
Supported by National High Technology Research and Development Program of China, No. 2012AA021103; the Program of Guangdong Provincial Department of Science and Technology, No. 2012A030400012; the Major Program of Science and Technology Program of Guangzhou, No. 201300000087; and the Sub-project under National Science and Technology Support Program, No. 2013BAI05B00
Correspondence to: Guo-Xin Li, MD, PhD, Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou 510515, Guangdong Province, China. gzliguoxin@163.com
Telephone: +86-20-61641682 Fax: +86-20-61641683
Received: December 8, 2013
Revised: January 22, 2014
Accepted: March 8, 2014
Published online: June 28, 2014
Abstract

AIM: To evaluate the feasibility, safety, and oncologic outcomes of laparoscopic extended right hemicolectomy (LERH) for colon cancer.

METHODS: Since its establishment in 2009, the Southern Chinese Laparoscopic Colorectal Surgical Study (SCLCSS) group has been dedicated to promoting patients’ quality of life through minimally invasive surgery. The multicenter database was launched by combining existing datasets from members of the SCLCSS group. The study enrolled 220 consecutive patients who were recorded in the multicenter retrospective database and underwent either LERH (n = 119) or open extended right hemicolectomy (OERH) (n = 101) for colon cancer. Clinical characteristics, surgical outcomes, and oncologic outcomes were compared between the two groups.

RESULTS: There were no significant differences in terms of age, gender, body mass index (BMI), history of previous abdominal surgery, tumor location, and tumor stage between the two groups. The blood loss was lower in the LERH group than in the OERH group [100 (100-200) mL vs 150 (100-200) mL, P < 0.0001]. The LERH group was associated with earlier first flatus (2.7 ± 1.0 d vs 3.2 ± 0.9 d, P < 0.0001) and resumption of liquid diet (3.6 ± 1.0 d vs 4.2 ± 1.0 d, P < 0.0001) compared to the OERH group. The postoperative hospital stay was significantly shorter in the LERH group (11.4 ± 4.7 d vs 12.8 ± 5.6 d, P = 0.009) than in the OERH group. The complication rate was 11.8% and 17.6% in the LERH and OERH groups, respectively (P = 0.215). Both 3-year overall survival [LERH (92.0%) vs OERH (84.4%), P = 0.209] and 3-year disease-free survival [LERH (84.6%) vs OERH (76.6%), P = 0.191] were comparable between the two groups.

CONCLUSION: LERH with D3 lymphadenectomy for colon cancer is a technically feasible and safe procedure, yielding comparable short-term oncologic outcomes to those of open surgery.

Keywords: Colon cancer, Laparoscopic surgery, Extended right hemicolectomy, D3 lymphadenectomy, Survival

Core tip: This multicenter retrospective study specially evaluates the feasibility, safety, and oncologic outcomes of laparoscopic extended right hemicolectomy with D3 lymphadenectomy for tumors located at the hepatic flexure or within 10 cm distal to the hepatic flexure. Results suggest that laparoscopic extended right hemicolectomy with D3 lymphadenectomy is a technically feasible and safe procedure, yielding comparable short-term oncologic outcomes to open surgery.