COMPARISON OF LAPAROSCOPIC VERSUS OPEN RIGHT HEMICOLECTOMY IN PATIENTS OF ASCENDING COLON TUMOR

Abstract

Background:  In addition to rectum, ascending colon and caecum can also develop cancer. Right hemicolectomy is the operation of choice for later two. Laparoscopic right hemicolectomy is reported to have advantages of minimal invasive surgery, but some contradictory results were found. So the purpose of this study is the quest of truth.

Objective: To compare the outcome of Laparoscopic and Open Right Hemicolectomy in patients of ascending colon tumors.

Methods: This randomized Controlled Trial was conducted at Surgical Unit II, LGH, Lahore for 12 months from 2020-2021. Then 90 patients (45 in each group) were enrolled based on inclusion criteria. In group A, laparoscopic and in group B, open method was performed. Duration of surgery, hospital stay, wound complications and anastomotic leakage were noted. Data was recorded on proforma and analyzed in SPSS Vr. 25.0. Both groups were compared for duration of surgery and hospital stay by using independent samples t-test and for wound complication and anastomotic leakage by using chi-square test. P-value<0.05 was taken as significant.

Results: The mean age of patients was 52.31±13.30 yrs in laparoscopic and 51.18±10.74 years in open surgery. In laparoscopy group, male:female ratio was 1:1 and in open surgery group it was 1:2. In laparoscopy mean duration of surgery was 125.18±19.66 minutes while in open group it was 134.20±25.07 minutes. (p-value >0.05). In laparoscopy mean duration of hospital stay was 6.47±1.24 days and in open surgery it was 7.96±1.35 days (p-value <0.05). In laparoscopy group, wound complication occurred in 4 (8.9%) patients and in open surgery group, wound complication occurred in 7 (15.6%) patients (p-value >0.05). In laparoscopy group no anastomotic leak occurred i.e. 0 (0.0%) patients, but in open surgery group, anastomotic leak occurred in 3 (6.7%) patients (p-value >0.05). In laparoscopy group, pain was mild in 41 (91.1%) cases while moderate in 4 (8.9%) cases and no patients had severe or excruciating pain. In open surgery group, pain was mild in 32 (71.1%) cases while moderate in 10 (22.2%) cases and 3 (6.7%) patients had severe pain but no patient had excruciating pain. The difference was significant (p-value <0.05).

Conclusion: Thus laparoscopic method has advantages in terms of reduced hospital stay, less postoperative pain, wound complications and anastomotic leakage after surgery as compared to open surgical method.

Key words: Laparoscopic surgery, Open surgery, Right Hemicolectomy, ascending colon tumor, anastomotic leak, wound complication, stapling device.