Abstract
Background
Access for right hemicolectomy can be gained by median or transverse incision laparotomy. It is not known whether these routes differ with regard to short-term postoperative outcomes.
Methods
Patients in the DGAV StuDoQ|ColonCancer registry who underwent open oncological right hemicolectomy by median (n = 2389) or transverse laparotomy (n = 1311) were compared regarding Clavien–Dindo classification (CDC) complications (primary endpoint) as well as specific postoperative complications, operation time, length of stay, and MTL30 status (secondary endpoints).
Results
A total of 3700 StuDoQ registry patients underwent open oncological right hemicolectomy by median (n = 2389) or transverse laparotomy (n = 1311) without additional interventions. The median and transverse access routes did not differ regarding CDC complication rates (CDC > =3a: 13.1% vs. 12.6%; p = 0.90). However, univariate and multivariate analyses showed that operation times (OR 0.71, 95% CI 0.62–0.81; p < 0.001), length of stay (OR 0.69, 95% CI 0.6–079; p < 0.001), and MTL30 (OR 0.7, 95% CI 0.61–0.81, p < 0.001) were significantly reduced in the transverse laparotomy group.
Conclusions
For oncological right hemicolectomy, open transverse upper abdominal laparotomy appears to be superior to median laparotomy in short-term course.
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Jurowich, C., Lichthardt, S., Matthes, N. et al. Comparison of conventional access routes for right hemicolectomy in colon cancer—data from the DGAV StuDoQ registry. Int J Colorectal Dis 34, 161–167 (2019). https://doi.org/10.1007/s00384-018-3188-2
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DOI: https://doi.org/10.1007/s00384-018-3188-2