Right Colon Resection for Colon Cancer: Does Surgical Approach Matter?

Ivy N. Haskins, Tammy Ju, Matthew Skancke, Xiangyu Kuang, Richard L. Amdur, Fred Brody, Vincent Obias, Samir Agarwal

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Materials and Methods: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database. Only patients with stage I, II, or III colon cancer were included. The association of surgical approach with oncologic results and 30-day morbidity and mortality outcomes was investigated using a variety of statistical tests. Results: A total of 3518 patients met inclusion criteria; 1024 (29.1%) underwent open surgery (OS), 2405 (63.4%) underwent laparoscopic surgery, and 89 (2.5%) underwent robotic surgery. Patients undergoing OS were significantly more likely to have positive resection margins (P <.001). Patients undergoing OS were significantly more likely to experience prolonged intubation (P =.02), deep wound infections (P =.001), wound dehiscence (P =.005), deep venous thrombosis (P =.04), bleeding requiring a blood transfusion (P <.001), a prolonged postoperative ileus (P <.001), and longer length of hospital stay (P <.001), and were more likely to die (P =.02). Conclusion: The laparoscopic approach to colon resection for colon cancer has lower 30-day morbidity compared to OS. The robotic approach is equivalent to the laparoscopic approach, and its utilization may increase in the future.

Original languageEnglish (US)
Pages (from-to)1202-1206
Number of pages5
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume28
Issue number10
DOIs
StatePublished - Oct 2018
Externally publishedYes

Keywords

  • Colon cancer
  • minimally invasive surgery
  • morbidity
  • mortality
  • right colon resection

ASJC Scopus subject areas

  • Surgery

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