Open Right Hemicolectomy: Lateral to Medial or Medial to Lateral Approach?

Authors：Xu Pingping; Ren Li; Zhu Dexiang; Lin Qi; Zhong Yunshi; Tang Wentao; Feng Qingyang; Zheng Peng; Ji Meiling; Wei Ye^*; Xu Jianmin

Source：PLoS ONE, 2015, 10(12): e0145175.

DOI：10.1371/journal.pone.0145175

Objective
Currently, no published studies have compared the clinical outcomes of the medial-to-lateral approach (MA) and lateral-to-medial approach (LA) for open right hemicolectomy. Thus, the present study aimed to assess whether one of these approaches has any potential benefits over the other.
Methods
A retrospective study was performed of all patients who underwent open right hemicolectomy with pathologically confirmed disease who met the eligibility criteria between June 2008 and June 2012. The population was divided into an MA group and an LA group by propensity scoring. We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes.
Results
A total of 450 patients (MA, n = 150; LA, n = 300) were evaluated. The operation time (MA, 138.4 minutesvs. LA, 166.2 minutes; P <.05) and blood loss (MA, 52.0mL vs. LA, 62.6mL; P <.05) were significantly lower in the MA group. No differences in the number of harvested lymph nodes and oncologic outcomes were observed between the two groups. Further subgroup analysis for stage III colon cancer revealed that the MA group had significantly more retrieved lymph nodes (MA, 18.8vs. LA, 16.0; P =.028). There were no differences in other variables between the two groups.
Conclusions
The MA reduced operative time and blood loss compared with the LA. We thus concluded that the MA provided short-term benefits compared with the LA in open right hemicolectomy for right-sided colon cancer.

• Institution
  复旦大学