Laparoscopic right hemicolectomy: comparison of medial and lateral approach

Abstract

Aim: We aimed to examine the early oncological and clinical outcomes of the medial and lateral approaches for right hemicolectomy. Materials and Methods: Laparoscopic right hemicolectomy patients who underwent medial and lateral approach techniques in our clinic between March 2010 and September 2022 were retrospectively reviewed. Demographic data of the patients, tumor, and operation characteristics, operation, clinical, pathological, mortality, and morbidity outcomes were recorded. Data were compared with the Chi-square test or Fisher Exact test according to the expected value for categorical variables. The Mann-Whitney U test was used because the data for continuous variables were not normally distributed. Results: In total, hundred and fourteen patients who underwent laparoscopic right colon resection were included. 47 patients were operated on with the medial approach, and 67 with the lateral approach. In terms of harvested lymph node number, operation time, estimated blood loss, first fluid intake, first solid intake, first flatus, blood transfusion history, length of stay, anastomotic leaks, and mortality were not significantly different between the two approaches (p>0.05). However, the number of positive lymph nodes was significantly higher in the medial approach (p=0.013). Conclusion: The medial and lateral approaches are feasible and effective techniques for right hemicolectomy. There is no difference between the short-term oncologic results. However, randomized controlled studies are needed for long-term results.