Right Colon Resection for Colon Cancer: Does Surgical Approach Matter?
Journal of Laparoendoscopic and Advanced Surgical Techniques
Colon cancer; minimally invasive surgery; morbidity; mortality; right colon resection
© 2018, Mary Ann Liebert, Inc. Background: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Materials and Methods: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database. Only patients with stage I, II, or III colon cancer were included. The association of surgical approach with oncologic results and 30-day morbidity and mortality outcomes was investigated using a variety of statistical tests. Results: A total of 3518 patients met inclusion criteria; 1024 (29.1%) underwent open surgery (OS), 2405 (63.4%) underwent laparoscopic surgery, and 89 (2.5%) underwent robotic surgery. Patients undergoing OS were significantly more likely to have positive resection margins (P <.001). Patients undergoing OS were significantly more likely to experience prolonged intubation (P =.02), deep wound infections (P =.001), wound dehiscence (P =.005), deep venous thrombosis (P =.04), bleeding requiring a blood transfusion (P <.001), a prolonged postoperative ileus (P <.001), and longer length of hospital stay (P <.001), and were more likely to die (P =.02). Conclusion: The laparoscopic approach to colon resection for colon cancer has lower 30-day morbidity compared to OS. The robotic approach is equivalent to the laparoscopic approach, and its utilization may increase in the future.
Haskins, I., Ju, T., Skancke, M., Kuang, X., Amdur, R., Brody, F., Obias, V., & Agarwal, S. (2018). Right Colon Resection for Colon Cancer: Does Surgical Approach Matter?. Journal of Laparoendoscopic and Advanced Surgical Techniques, 28 (10). http://dx.doi.org/10.1089/lap.2018.0148