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Research Paper | Surgery | India | Volume 14 Issue 1, January 2025 | Popularity: 4.8 / 10

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Randomized Control Trial: Comparison Between Laparoscopic Versus Open Right Hemicolectomy

Dr. Dinesh Kumar Bhamu, Dr. R. K. Kajla, Dr. Yogesh Sadh, Dr. Mahavir Prasad, Dr. Radhika Agarwal, Dr. Surendra Kumar Jat

Abstract: Background: Advancements in colorectal surgery have introduced laparoscopic techniques as a minimally invasive alternative to traditional open surgery for right hemicolectomy. While laparoscopic surgery offers benefits such as reduced blood loss, shorter hospital stays, and improved cosmetic outcomes, it remains technically demanding, particularly for advanced malignancies. This study compares the short - term outcomes of laparoscopic versus open right hemicolectomy. Aim: To evaluate and compare laparoscopic and open right hemicolectomy in terms of operative time, oncological clearance, cosmetic outcomes, hospital stay, early complications, and short - term recurrence. Methods: A prospective randomized control trial was conducted at S. P. Medical College and P. B. M. Hospital, Bikaner, over 19 months. A total of 46 patients were randomized into two groups: Group A (laparoscopic, 23 patients) and Group B (open surgery, 23 patients). Data were collected on demographics, clinical presentations, operative metrics, and postoperative outcomes. Standardized protocols were followed, and patients were monitored for 30 - day complications and short - term recurrence. Results: Laparoscopic surgery demonstrated significantly shorter hospital stays (7.69 vs.13.35 days, p=0.0001), reduced blood loss (106.25 vs.369.13 ml, p=0.0001), shorter incision lengths (7.13 vs.15.65 cm, p=0.0001), and fewer complications (0% vs.34.78% wound infections, p=0.0001). However, laparoscopic procedures required longer operative times (210 vs.152.61 minutes, p=0.0001). Oncological clearance, including lymph nodes harvested, was comparable between groups. Advanced - stage tumors (T4) were managed exclusively via open surgery due to technical challenges with laparoscopic techniques. Conclusion: Laparoscopic right hemicolectomy offers substantial benefits over open surgery, including faster recovery, better cosmetic outcomes, and fewer complications, making it a preferable choice for benign conditions and early - stage malignancies. Open surgery remains crucial for advanced malignancies and cases requiring conversion. Enhanced surgical expertise and advanced equipment are essential for optimizing laparoscopic outcomes.

Keywords: Right hemicolectomy, laparoscopic surgery, open surgery, colorectal cancer, minimally invasive surgery, oncological outcomes

Edition: Volume 14 Issue 1, January 2025

Pages: 1230 - 1232

DOI: https://www.doi.org/10.21275/SR25127204418

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