Surgical approach to right colon cancer: From open technique to robot. State of art

Table 1 Laparoscopic vs open right colectomy: Comparison of short term outcomes

Ref.	Patient number LS/OS	Mean operative time (min) LS/OS	Blood loss (mL) LS/OS	Harvested nodes LS/OS	First flatus/defecation (d) LS/OS	P.O. Complications (patients) LS/OS	Hospital stay LS/OS	Mortality LS/OS
Ramacciato et al[20]	33/33	251/222.91	135/4041	12.7/181	3.15/3	1/41	11.2/13.81	0/0
Khan et al[21]	89/75	120/NR	NR	15/13	NR	0/41	4/81	0/41
Veldkamp et al[22]	627/621	145/1151	100/1751	NS	3.6/4.61	NS	8.2/9.31	NS
Lohsiriwat et al[23]	13/20	207.7/104.51	120/107	29.2/18.8	2.4/2.6	1/0	6.2/7.1	0/0
Guillou et al[24]	484/253	NR	NR	12/35	5/6	NR	9/11	21/13
Abdel-Halim et al[25]	22/34	187/1301	NR	23.8/21.2	3/41	4/9	6/101	1/2
Zhao et al[26]	119/101	170.7/244.4	100/1501	22.3/21.8	2.7/3.21	11.8/17.6%	11.4/12.81	1/1

¹Data are statistically significant (P < 0.05). NS: Data are not statistically significant; NR: Data are not reported; LS: Laparoscopy; OS: Open surgery.

Table 2 Totally laparoscopic right colectomy vs laparoscopic assisted right colectomy: Comparison of short term outcomes

Ref.	Patient number TLC/LAC	Length of skin incision (mm) TLC/LAC	Mean operative time (min) TLC/LAC	Blood loss (mL) TLC/LAC	Harvested nodes TLC/LAC	First flatus/defecation (d) TLC/LAC	P.O. Complications (patients) TLC/LAC	Hospital stay TLC/LAC	Mortality TLC/LAC
Roscio et al[33]	42/30	48.2/711	176.5/186.3	31.2/43.3	25.9/22	2.9/3.41	1/2	6.2/7.21	0/1
Fabozzi et al[32]	50/50	60/1201	78/921	NR	16/17	1.3/2.61	0/141	5.3/7.61	0/0
Scatizzi et al[35]	40/40	50/40	150/150	NR	30/26	0/1	3/3	5/5	0/0
Hellan et al[36]	23/57	40/501	190/180	50/100	18/17	NS	6/14	4/4	0/1
Magistro et al[9]	40/40	55/721	230/2031	NR	22/20	2.2/2.61	7/8	6.3/6	0/1
Chaves et al[37]	35/25	NR	226/2081	NR	20.6/14.2	3/41	7/5	6/81	1/1
Grams et al[38]	54/51	NR	190/1561	NS	NR	2/2.4	6/15	3.2/3.81	1/1

¹Data are statistically significant (P < 0.05). NS: Data are not statistically significant; NR: Data are not reported; TLC: Totally laparoscopic right colectomy; LAC: Laparoscopic assisted right colectomy.

Table 3 Comparison between different minilaparotomies in right colectomies

Laparotomy	Suprapubic	Right hypocondrium
Dimension	↓	↑
Wound infection	↓	↑
Incisional hernia	↓	↑
P.O. pain	↓	↑
Respiratory function	↓	↑

From Fabozzi et al[32].

Table 4 Comparison between open right colectomy, laparoscopic assisted right colectomy, totally laparoscopic right colectomy, single incision laparoscopic Surgery for right colon and robotic right colectomy

Parameters	Open right colectomy	LAC	TLC	SILC	RRC
Laparotomy site and dimension	Transverse (on right side ) Median (10-12 cm)	Transverse (on right side) (7-13.5 cm)	Suprapubic (48-13 cm)	Suprapubic Umbilical (median) (3-4.5 cm)	Suprapubic (4-6 cm)
Type of anastomosis	EA	EA	IA	IA/EA	IA
3D vision	Yes	No	No	No	Yes
Surgeon hand tremor filtering	No	No	No	No	Yes
High-precision movements and suturing	No	No	No	No	Yes
Technical difficulty	↓	↑	↑↑	↑↑↑	↓
Surgeon’s comfort (dock station)	↓	↓	↓	↓↓↓	↑
Patient’s comfort	↓	↓	↑↑	↑↑	↑↑
Costs	↓	↑	↑	↑	↑↑↑

LAC: Laparoscopic assisted right colectomy; TLC: Totally laparoscopic right colectomy; SILC: Single incision laparoscopic surgery for right colon; RRC: Robotic right colectomy.