Minimally Invasive versus Open Approach for Right-Sided Colectomy: A Study in 12,006 Patients from the Dutch Surgical Colorectal Audit

Dig Surg. 2019;36(1):27-32. doi: 10.1159/000486400. Epub 2018 Feb 7.

Abstract

Background: There is ongoing debate whether laparoscopic right colectomy is superior to open surgery. The purpose of this study was to address this issue and arrive at a consensus using data from a national database.

Methods: Patients who underwent elective open or laparoscopic right colectomy for colorectal cancer during the period 2009-2013 were identified from the Dutch Surgical Colorectal Audit. Complications that occurred within 30 days after surgery and 30-day mortality rates were calculated and compared between open and laparoscopic resection.

Results: In total, 12,006 patients underwent elective open or laparoscopic surgery for right-sided colorectal cancer. Of these, 6,683 (55.7%) underwent open resection and 5,323 (44.3%) underwent laparoscopic resection. Complications occurred within 30 days after surgery in the laparoscopic group in 26.1% of patients and in 32.1% of patients in the open group (p < 0.001). Thirty-day mortality was also significantly lower in the laparoscopic group (2.2 vs. 3.6% p < 0.001).

Conclusion: In this non-randomized, descriptive study conducted in the Netherlands, open right colectomy seems to have a higher risk for complications and mortality as compared to laparoscopic right colectomy, even after correction for confounding factors.

Keywords: Colon cancer; Laparoscopy; Right colectomy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colectomy / adverse effects
  • Colectomy / methods*
  • Colectomy / mortality
  • Colon, Ascending / surgery
  • Colon, Transverse / surgery
  • Colonic Neoplasms / surgery*
  • Databases, Factual
  • Female
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Netherlands
  • Postoperative Complications / etiology
  • Reoperation
  • Retrospective Studies