CR10 LAPAROSCOPIC RIGHT HEMICOLECTOMY PERFORMED DURING THE ‘LEARNING CURVE PHASE’ DOES NOT IMPACT ON ONCOLOGICAL RESECTION

Abstract

Purpose Laparoscopic colectomy for the management of colonic neoplasia is technically feasible and increasingly popular. It is expected that the laparoscopic operation deliver similar oncological clearance to open operation. The ‘learning curve’ for laparoscopic right hemicolectomy has been estimated to be 20 cases and is now set as a guideline by ASCRS. This study was performed to compare histopathology specimens following laparoscopic right hemicolectomy (LRH) performed during the ‘learning curve’ phase with those following open right hemicolectomy (ORH) to evaluate oncological clearance of colonic neoplasms.Methods 125 patients were identified as having undergone right hemicolectomy by two surgeons for colonic neoplasia from January 2001. Data regarding patient details and tumour pathology were obtained by retrospective case note review. Thirty‐five patients underwent LRH compared to 90 who had ORH during the same period. Histopathology from the two groups were compared for length of specimen resected, proximal and distal resection margins, size of tumour resected or number of lymph nodes harvested. Analysis was performed using Student’s T‐test.Results The two groups were matched with respect to age, sex and tumour characteristics. There was no significant difference between the groups in terms of length of specimen resected (p = 0.37), proximal (p = 0.29) and distal (p = 0.40) resection margins, size of tumour resected (p = 0.37) or number of lymph nodes harvested (p = 0.58).Conclusions ‘Learning curve’ laparoscopic right hemicolectomy allows similar lymphovascular clearance to traditional open surgery.