Three-Port Laparoscopic Right Colectomy Versus Conventional Five-Port Laparoscopy for Right-Sided Colon Cancer

초록

Background: The purpose of the study was to evaluate the safety and effectiveness of three-port laparoscopic right colectomy (3-LRC) for right-sided colon cancer compared with conventional five-port laparoscopic right colectomy (5-LRC). Materials and Methods: One hundred sixty-three patients diagnosed with right-sided colon adenocarcinoma underwent laparoscopic right colectomy (LRC) between April 2011 and December 2017. Seventy-four of these patients underwent 3-LRC procedure and 89 patients underwent 5-LRC. Clinical characteristics, perioperative short-term outcomes, and pathologic data were analyzed. Results: There were no differences in TNM stage, tumor location, estimated blood loss, complications, and open conversion rates. The operation time was shorter in the 3-LRC group than in 5-LRC group (140.927.5 minutes versus 178.2 +/- 38.2 minutes; P=.001). The number of harvested lymph nodes (28.5 +/- 13.9 versus 22.6 +/- 11.7; P=.004) was also higher in the 3-LRC group. The first passage of flatus and first oral diet were significantly faster in the 3-LRC group than in the 5-LRC group (2.8 +/- 1.0 days versus 4.0 +/- 1.2 days; P=.001, 3.6 +/- 2.9 days versus 5.0 +/- 1.5 days; P=.001). The number of patients who required analgesics is less in the 3-LRC group (32.4% versus 43.8%; P=.583). Conclusion: 3-LRC for right-sided colon cancer is technically feasible and is associated with a short operation time. We believe that 3-LRC effectively reduces the costs associated with equipment and manpower and represents a standard procedure.

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