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Erschienen in:
01.06.2012 | Original Article
A comparison of short-term outcome after laparoscopic, transverse, and midline right-sided colectomy
Erschienen in: International Journal of Colorectal Disease | Ausgabe 6/2012
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Aim
The aim of the present study was to compare the laparoscopy, transverse, and midline laparotomy in right-sided colectomies with respect to short- and long-term outcome.
Methods
The short- and long-term results of all patients who had an elective right-sided hemicolectomy, from January 2006 to April 2009 for malignant or benign disease, were evaluated according to the surgical technique: laparoscopic, midline, or transverse incision laparotomy.
Results
The 75 included patients (41% male) had laparoscopy (n = 30), midline (n = 22), or transverse incision laparotomy (n = 23). Median operating time in the laparoscopy group was significantly longer in comparison to the midline and transverse incision groups (129, 105, and 101 min respectively, p < 0.001). Short-term follow-up revealed a longer median total length of stay in the midline laparotomy group compared to the other groups (9 vs. 7 days, p = 0.026). Thirty-day morbidity was less in the laparoscopy and transverse incision groups compared to the midline laparotomy group (15%, 20%, and 41%; p = 0.06). After excluding patients who had a previous midline incision, an earlier return of bowel function was seen for laparoscopy and transverse hemicolectomy (3 vs. 5 days, p = 0.017). At a median follow-up of 40 months (21–58), four incisional hernias occurred, two in the midline laparotomy group (one operatively corrected) and two in the laparoscopy group.
Conclusions
Although the results of this study need to be interpreted with care, our study shows that laparoscopic and transverse right hemicolectomy are equivalent and have a significant better short-term outcome compared to an open midline approach. In particular, laparoscopy and transverse laparotomy result in >50% reduction in 30-day morbidity, no reoperations, and a shorter median total hospital stay of 2 days.