Published online Jun 27, 2013. doi: 10.4240/wjgs.v5.i6.187
Revised: May 16, 2013
Accepted: June 1, 2013
Published online: June 27, 2013
Processing time: 81 Days and 16.4 Hours
AIM: To compare short term outcomes of elective laparoscopic and open right hemicolectomy (RH) in an elderly population.
METHODS: All patients over the age of 70 undergoing elective RH at Ninewells Hospital and Perth Royal Infirmary between January 2006 and May 2011 were included in our analysis. Operative details, hospital length of stay, morbidity and mortality was collected by way of proforma from a dedicated prospective database. An extracorporeal anastomosis was performed routinely in the laparoscopic group. The primary endpoints for analysis were morbidity and mortality. Our secondary endpoints were operative duration, length of hospital stay and discharge destination.
RESULTS: Two hundred and six patients were included in our analysis. One hundred and twenty-five patients underwent an open resection and 81 patients had a laparoscopic resection. The mean operating time was significantly longer in the laparoscopic group (139 ±
36 min vs 197 ± 53 min, P = 0.001). The mean length of hospital stay was similar in both groups (11.2 ± 7.8 d vs 9.6 ± 10.7 d, P = 0.28). The incidence of post-operative morbidities was 27% in the open group and 38% in the laparoscopic group (P = 0.12). Overall in-hospital mortality was 0.8% in open procedures vs 1% in laparoscopic.
CONCLUSION: Laparoscopic RH was associated with a significantly longer operative time compared to open RH. In our study, laparoscopic RH was not associated with reduced post-operative morbidity or significantly shorter length of hospital stay.
Core tip: This is the first study to assess open versus laparoscopic right hemicolectomy in the elderly population. Our results, whilst comparable to the published literature, do not show any benefits in terms of operative or short-term outcomes in laparoscopic surgery over open surgery in this particular group of patients.