Comparison between midline and right transverse incision in right hemicolectomy for right-sided colon cancer: a retrospective study

The advantage of a transverse incision over a midline incision for open right hemicolectomy remains controversial.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.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.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.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.