Abstract
Laparoscopic right hemicolectomy (LRH) is utilized worldwide as one of the standard surgical treatments for right‐sided colon cancer. However, there have been issues concerning its applicability, techniques, and trend. The present study aimed to elucidate the current status and trend of LRH by reviewing literature focusing on important issues associated with this surgery. Based on previous studies, LRH most likely provides better short‐term outcomes and similar oncological outcomes compared to open surgery. Despite the increasing use of robotic approach in this surgery, it seems to have always been associated with longer operative times and greater hospital cost with limited advantage. Intracorporeal anastomosis seems to improve short‐term outcomes, such as quicker recovery of bowel function, compared to extracorporeal anastomosis. However, it does not contribute to shorter hospital stay. With regard to dissection technique, various approaches, and landmarks have been advocated to overcome the technical difficulty in LRH. This difficulty is likely to be caused by anatomical variation, especially in venous structures. The superiority of one approach or landmark over another is still argued about due to the lack of large‐scale prospective studies. However, deep understanding both of anatomical variation and characteristics of each approach would be of extreme importance to minimize adverse effects and maximize patient benefit after LRH.
Highlights
N most common procedures in colorectal cancer surgery, which is employed for right-sided colon cancer
According to the retrospective comparative study by Rotholtz et al in 2009, the operative time for Laparoscopic right hemicolectomy (LRH) was significantly shorter in the medial-to-lateral approach than in the lateral-to-medial approach (148.6 min vs 185.6 min; P = .009); the morbidity and mortality did not differ between the groups.[30]
Surgery with intracorporeal anastomosis (IA) had the interesting study employing 4034 patients with stage III colon a longer operative time, it resulted in shorter wound length (6.7 cm cancer by Kataoka et al, the right-sided vs 8.7 cm; P < .001), quicker recovery of digestive function (2.3 days cancers more frequently invaded main lymph nodes than left-sided vs 3.3 days; P = .003), lower incidence of paralytic ileus (13% vs 30%; lesions (8.5% vs 3.7%; P < .001) and the proportion of patients with
Summary
Current status and trend of laparoscopic right hemicolectomy for colon cancer Takeru Matsuda[1,2].
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