Comparison between Midline and Right Transverse Incision in Right Hemicolectomy for Right-Sided Colon Cancer: A Retrospective Study†
Varut Lohsiriwat MD*, Darin Lohsiriwat MD*, Wiroon Boonnuch MD*, Vitoon Chinswangwatanakul MD, PhD*, Thawatchai Akaraviputh MD*, Asada Methasade MD, PhD*, Narong Lertakyamanee MD*
Affiliation : † The abstract of this manuscript was presented as a poster presentation at the 2nd Scientific Meeting of European Society of Coloproctology, 26th-29th September 2007, Malta * Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : The advantage of a transverse incision over a midline incision for open right hemicolectomy
remains controversial.
Objective : To compare the short-term surgical outcomes of right hemicolectomy through midline incision
(RHML) and right hemicolectomy through right transverse incision (RHTR) for right-sided colon cancer.
Material and Method: This retrospective study included 74 patients with right-sided colon cancer who
underwent elective right hemicolectomies through midline or right transverse incision between February
2004 and June 2006 at the Department of Surgery, Faculty of Medicine Siriraj Hospital. Operative details,
postoperative requirement of narcotics, recovery of bowel function, and oncological parameters were analyzed.
Results : Fifty-four patients underwent RHML and 20 patients underwent RHTR. Both approaches achieved
adequate oncological resection of the tumor. The RHTR group were characterized by shorter operative
times (105 vs. 140 minutes; p = 0.001), less blood loss (70 vs. 125 ml; p = 0.004), faster discontinuation of
intravenous narcotics (1.2 vs. 1.8 days; p = 0.03), and shorter length of hospital stay (6.0 vs. 7.9 days; p =
0.02). Postoperative complications and time to recovery of bowel function were not significantly different.
Conclusion : The authors suggest that RHTR is a safe and effective operation for right-sided colon cancer,
which results in a significant reduction in operative time, duration of intravenous narcotics administration,
and hospital stay compared with RHML. However, there is no difference in postoperative recovery of bowel
function and complication rate.
Keywords : Colon cancer, Colectomy, Hemicolectomy, Incision, Transverse
