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Open Right Hemicolectomy:Lateral to Medial or Medial to Lateral Approach?

Xu P, Ren L, Zhu D, Lin Q, Zhong Y, Tang W, Feng Q, Zheng P, Ji M, Wei Y, Xu J - PLoS ONE (2015)

Bottom Line: We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes.LA,62.6mL; P < .05)were significantly lower in the MA group.There were no differences in other variables between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

ABSTRACT

Objective: Currently, no published studies have compared the clinical outcomes of the medial-to-lateral approach (MA) and lateral-to-medial approach (LA) for open right hemicolectomy. Thus, the present study aimed to assess whether one of these approaches has any potential benefits over the other.

Methods: A retrospective study was performed of all patients who underwent open right hemicolectomy with pathologically confirmed disease who met the eligibility criteria between June 2008 and June 2012. The population was divided into an MA group and an LA group by propensity scoring. We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes.

Results: A total of 450 patients (MA, n = 150; LA, n = 300) were evaluated. The operation time (MA,138.4 minutesvs.LA,166.2 minutes; P < .05) and blood loss (MA,52.0mL vs. LA,62.6mL; P < .05)were significantly lower in the MA group. No differences in the number of harvested lymph nodes and oncologic outcomes were observed between the two groups. Further subgroup analysis for stage III colon cancer revealed that the MA group had significantly more retrieved lymph nodes (MA,18.8vs. LA,16.0; P = .028). There were no differences in other variables between the two groups.

Conclusions: The MA reduced operative time and blood loss compared with the LA. We thus concluded that the MA provided short-term benefits compared with the LA in open right hemicolectomy for right-sided colon cancer.

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Related in: MedlinePlus

Kaplan-Meier estimates of survival between the MA group and the LA group for stage II colon cancer.Kaplan-Meier analysis of OS(P = .532) and DFS(P = .788).
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pone.0145175.g002: Kaplan-Meier estimates of survival between the MA group and the LA group for stage II colon cancer.Kaplan-Meier analysis of OS(P = .532) and DFS(P = .788).

Mentions: In subgroup analysis of stage II and stage III colon cancer, the 5-year OS of both stage II right-sided colon cancer (MA, 88%vs. LA 82%; P = .532) and stage III colon cancer (MA,72%vs. LA 62%; P = .621) were comparable between the MA and LA groups. Meanwhile, no difference was found in the 5-year DFS rates for stage II right-sided colon cancer (MA, 79%vs. LA 78%; P = .788) or stage III colon cancer (MA, 71%vs. LA 60%; P = .287), as shown in Figs 2 and 3.


Open Right Hemicolectomy:Lateral to Medial or Medial to Lateral Approach?

Xu P, Ren L, Zhu D, Lin Q, Zhong Y, Tang W, Feng Q, Zheng P, Ji M, Wei Y, Xu J - PLoS ONE (2015)

Kaplan-Meier estimates of survival between the MA group and the LA group for stage II colon cancer.Kaplan-Meier analysis of OS(P = .532) and DFS(P = .788).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697815&req=5

pone.0145175.g002: Kaplan-Meier estimates of survival between the MA group and the LA group for stage II colon cancer.Kaplan-Meier analysis of OS(P = .532) and DFS(P = .788).
Mentions: In subgroup analysis of stage II and stage III colon cancer, the 5-year OS of both stage II right-sided colon cancer (MA, 88%vs. LA 82%; P = .532) and stage III colon cancer (MA,72%vs. LA 62%; P = .621) were comparable between the MA and LA groups. Meanwhile, no difference was found in the 5-year DFS rates for stage II right-sided colon cancer (MA, 79%vs. LA 78%; P = .788) or stage III colon cancer (MA, 71%vs. LA 60%; P = .287), as shown in Figs 2 and 3.

Bottom Line: We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes.LA,62.6mL; P < .05)were significantly lower in the MA group.There were no differences in other variables between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

ABSTRACT

Objective: Currently, no published studies have compared the clinical outcomes of the medial-to-lateral approach (MA) and lateral-to-medial approach (LA) for open right hemicolectomy. Thus, the present study aimed to assess whether one of these approaches has any potential benefits over the other.

Methods: A retrospective study was performed of all patients who underwent open right hemicolectomy with pathologically confirmed disease who met the eligibility criteria between June 2008 and June 2012. The population was divided into an MA group and an LA group by propensity scoring. We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes.

Results: A total of 450 patients (MA, n = 150; LA, n = 300) were evaluated. The operation time (MA,138.4 minutesvs.LA,166.2 minutes; P < .05) and blood loss (MA,52.0mL vs. LA,62.6mL; P < .05)were significantly lower in the MA group. No differences in the number of harvested lymph nodes and oncologic outcomes were observed between the two groups. Further subgroup analysis for stage III colon cancer revealed that the MA group had significantly more retrieved lymph nodes (MA,18.8vs. LA,16.0; P = .028). There were no differences in other variables between the two groups.

Conclusions: The MA reduced operative time and blood loss compared with the LA. We thus concluded that the MA provided short-term benefits compared with the LA in open right hemicolectomy for right-sided colon cancer.

Show MeSH
Related in: MedlinePlus