SP8.5 Emergency laparoscopic and open right hemicolectomy for right colonic malignancy: A retrospective comparative single centre study

Abstract

Abstract Aim Minimally invasive surgery has gained wide acceptance in general surgery and is being increasingly used to treat colon cancers. However, there are no randomized controlled trials comparing laparoscopic against open emergency colectomies. This study aims to compare the clinical and pathological outcomes for laparoscopic and open right colectomy in the emergency setting. Methods This single-centre study involved a total of 201 patients who underwent emergency laparoscopic and/or open right hemicolectomy for right colonic malignancy between 2009 and 2019. Results A total of 201 right colectomies were performed. Among these procedures, 84 were operated laparoscopically and 117 with an open midline laparotomy. In the laparoscopic group, 13 were converted to open procedures. Patient demographics were similar across both groups with regard to age, sex, BMI, ASA grade, and tumour stage. Patients in the laparoscopic group had significantly shorter hospital stays [Median = 8 vs. 13 days], higher number of lymph nodes harvested [Median = 22 vs 18]. Postoperative ileus was less common in the open group than in the laparoscopic group [9(7.7%) vs 7(8.3%), P= 1.000]. There was no significant difference in major complications, anastomotic leak, and mortality. Median 5-year DFS for the laparoscopic group was 9.9 months in comparison to 9.7 months. Median OS for the laparoscopic group was 15.6 months compared to 12.3 months in the open group. Conclusions Emergency laparoscopic right hemicolectomy seems to be safe with equivalent oncological outcomes to open surgery. Randomized control trials are required to further investigate the role of laparoscopy in emergency surgery for right colon cancers.