TY  - JOUR
A1  - Jurowich, Christian
A1  - Lichthardt, Sven
A1  - Kastner, Caroline
A1  - Haubitz, Imme
A1  - Prock, Andre
A1  - Filser, Jörg
A1  - Germer, Christoph-Thomas
A1  - Wiegering, Armin
T1  - Laparoscopic versus open right hemicolectomy in colon carcinoma: A propensity score analysis of the DGAV StuDoQ|ColonCancer registry
JF  - PLoS ONE
N2  - Objective
To assess whether laparoscopy has any advantages over open resection for right-sided colon cancer.

Summary background data
Right hemicolectomy can be performed using either a conventional open or a minimally invasive laparoscopic technique. It is not clear whether these different access routes differ with regard to short-term postoperative outcomes.

Methods
Patients documented in the German Society for General and Visceral Surgery StuDoQ|ColonCancer registry who underwent right hemicolectomy were analyzed regarding early postoperative complications according to Clavien-Dindo (primary endpoint), operation (OP) time, length of postoperative hospital stay (LOS), MTL30 and number of lymph nodes retrieved (secondary endpoints).

Results
A total of 4.997 patients were identified as undergoing oncological right hemicolectomy without additional interventions. Of these, 4.062 (81.3%) underwent open, 935 (18.7%) laparoscopic surgery. Propensity score analysis showed a significantly shorter LOS (OR: 0.55 CI 95%0.47-.64) and a significantly longer OP time (OR2.32 CI 1.98–2.71) for the laparoscopic route. Risk factors for postoperative complications, anastomotic insufficiency, ileus, reoperation and positive MTL30 were higher ASA status, higher age and increasing BMI. The surgical access route (open / lap) had no influence on these factors, but the laparoscopic group did have markedly fewer lymph nodes retrieved.

Conclusion
The present registry-based analysis could detect no relevant advantages for the minimally invasive laparoscopic access route. Further oncological analyses are needed to clarify the extent to which the smaller lymph node harvest in the laparoscopic group is accompanied by a poorer oncological outcome.
KW  - Laparoscopy
KW  - Lymph nodes
KW  - Minimally invasive surgery
KW  - Surgical oncology
KW  - Oncology
KW  - Surgical and invasive medical procedures
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-202184
VL  - 14
IS  - 6
ER  -