Clinical Analysis Of Laparoscopic-assisted Right Hemicolectomy For Right Colon Carcinoma And Open Operation

Objective:Compare the clinical effect between the laparoscopic assisted right hemicolectomy(LRH) and open right hemicolectomy (ORH). Investigate the safety and efficacy oflaparoscopic assisted right hemicolectomy. Provide the clinical basis for laparoscopic-assisted right hemicolectomy.Method:A retrospective analysised the clinical data of21cases of laparoscopic-assisted righthemicolectomy (LRH group) and50cases of open right hemicolectomy (ORH group). Andcompare the operation time, postoperative hospital stay time, amount of blood loss,number of lymph node dissection, postoperative anal exhaust time, operation costs,postoperative complications and follow-up.Results:Operation time: the LRH group is longer than that of the ORH group [(229.9±24.1)min vs (163.3±11.2) min, P=0.000], has statistical significance; Amount of blood loss: theLRH group is less than that of the ORH group [(52.9±17.7) ml vs.(98±15.9) ml, P=0.001],has statistical significance; Lymph node numbers: there is no significant differencebetween the two groups [15.8±2.1vs.15.3±1.0, P=0.646]; Postoperative hospital stay: theLRH group is shorter than that of the ORH group [(8.9±2.2) days vs.(12.8±1.6) days,P=0.016], has statistical significance; Anal exhaust time after operation: the LRH group isshorter than that of the ORH group [(40.6±2.6) h vs.(47.0±2.8) h, P=0.007], has statisticalsignificance; Operation cost: the LRH group is expensive than that of the ORH group,[(4986.0±728.2)Yuan vs.(3194.0±298.9) Yuan, P=0.000], has statistical significance; Complications: there is no significant difference between the two groups [9.5%(2/21) vs.10%(5/50), P=0.335].Follow-up: In all patients,2cases of open group were lost to follow-up,1case of apatient of Duck D,1case of a patient of Duck C.1case of a patient died of a car accidentout group, all other patients obtained (6-40) months follow-up. LRH group are (28.18±9.72)months, a total of7patients died, including4cases of local recurrence,2cases of livermetastasis,1case of lung metastasis. Short-term (40months) the cumulative survival ratewas66.67%. The open group are (30.22±7.04) months,14patients died, including7casesof local recurrence,2cases of liver and lung metastasis,2cases of liver metastasis,3casesof bone metastasis, short-term (40months) the cumulative survival rate was70.21%.Conclusion:1. Laparoscopic-assisted right hemicolectomy is safe and effective for colon cancer.2. It has the advantages of little trauma, rapid postoperative recovery, surgicalincision aesthetic to the patient.3. In the aspects of blood loss, postoperative hospital stay, postoperative recovery ofgastrointestinal function, etc. laparoscopic operation are better than open surgery. There islittle difference in intraoperative lymph node numbers with open surgery.4. But the operation time is longer, also need a learning curve.