Laparoscopic vs. Open Right Hemicolectomies: Short Term Outcomes within an Enhanced Recovery After Surgery ProgrammeChanpreet Arhi*, Lilly Wheeler, Isobel Duggan, Hasan Khan, Gnananandan Janakan, Dominic Corry, Rajab Kerwat, Ahmed El-Gaddal
Division of General Surgery, Queen Elizabeth Hospital, London, UK
- *Corresponding Author:
- Chanpreet Arhi
Specialty Registrar in the Division of General Surgery
Queen Elizabeth Hospital, London, UK
Received Date: January 30, 2014; Accepted Date: December 23, 2014; Published Date: December 28, 2014
Citation: Arhi C, Wheeler L, Duggan I, Khan H, Janakan G, et al. Laparoscopic vs.Open Right Hemicolectomies: Short Term Outcomes within an Enhanced Recovery After Surgery Programme. Journal of Surgery [Jurnalul de chirurgie] 2014; 10(3):209-212 doi: 10.7438/1584-9341-10-3-5
Copyright: © 2014 Arhi C. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aims: Studies that recommend laparoscopic right hemicolectomies within an Enhanced Recovery After Surgery (ERAS) programme are based on data from all types of colorectal procedures. This study compares short-term outcomes following right hemicolectomies within an ERAS setting.
Methods: Retrospective analysis of elective right hemicolectomies carried out between October 2008 and April 2012. Exclusion criteria:- patients not managed with an ERAS programme; inflammatory bowel disease; ASA IV and above; extended right hemicolectomy; formation of a stoma. Patients were split into laparoscopic (Group A) and open procedure (Group B). Patient demographics, hospital stay, operative details, tumour characteristics, analgesia usage and complications were compared between the two groups. Discharge criteria was standardised for both groups. Significance was taken as p <0.05.
Results: 32 patients were included in Group A and 37 patients in Group B. No significant difference in terms of sex, mean age, ASA grade, tumour stage, lymph node yield and epidural usage. BMI was statistically higher in Group A (27.9 vs. 24,8 kg/m2). Four laparoscopic procedures were converted to open. There were two anastomotic leaks in group B. No significant difference in complication rates. Median post-operative stay for Group A was significantly less at 5 days compared to 7 days for Group B. Patients in Group A also opened their bowels earlier (median day 4 vs. 5).
Conclusions: Our study demonstrates that in the setting of ERAS, laparoscopic right hemicolectomies are associated with a shorter hospital stay without an increase in complication rate compared to the open method.