Chanpreet Arhi, Lilly Wheeler, Isobel Duggan, Hasan Khan, Gnananandan Janakan, Dominic Corry, Rajab Kerwat, and Ahmed El-Gaddal
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.
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