Our Summary

This research paper is looking at two different types of surgery for right colon cancer. One type is laparoscopy-assisted right colectomy (LARC) which involves making a small incision and using a camera to guide the surgery, and then removing part of the colon through a larger incision. The other type is totally laparoscopic right colectomy (TLRC) where the entire surgery is done through small incisions using a camera and instruments.

The researchers compared the results of 120 patients who underwent TLRC and 180 who had LARC surgeries from 2016 to 2019. They found that those who had the fully laparoscopic surgery (TLRC) had less blood loss and smaller incisions. They also experienced less pain after surgery, needed fewer painkillers, and recovered faster in terms of bowel function and being able to eat and be discharged from the hospital.

The rate of postoperative complications was similar between the two groups. The researchers concluded that the fully laparoscopic surgery (TLRC) is safe and could lead to better cosmetic results, less pain, and faster recovery.

FAQs

  1. What are the two types of surgeries for right colon cancer discussed in the research paper?
  2. What were the main differences found between the patients who underwent TLRC and those who had LARC surgeries?
  3. Is the totally laparoscopic right colectomy (TLRC) considered safe according to the research findings?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic colectomy is to discuss with your surgeon the option of having a totally laparoscopic procedure (TLRC) rather than a laparoscopy-assisted procedure (LARC). The TLRC procedure may result in less blood loss, smaller incisions, less pain, and a faster recovery time compared to the LARC procedure. It is important to weigh the potential benefits of a fully laparoscopic surgery against any potential risks and discuss this with your surgeon to determine the best approach for your specific case.

Suitable For

Patients who are typically recommended for laparoscopic colectomy include those with right colon cancer, benign colorectal disease, inflammatory bowel disease, diverticulitis, and other conditions that require removal of part of the colon. Additionally, patients who are generally healthy and able to tolerate general anesthesia are good candidates for laparoscopic colectomy.

Timeline

Before the laparoscopic colectomy:

  1. Patient is diagnosed with right colon cancer and consulted with a surgical team.
  2. Patient undergoes preoperative tests and evaluations to determine their eligibility for surgery.
  3. Patient is informed about the procedure, potential risks and benefits, and postoperative care instructions.
  4. Patient may need to make lifestyle changes or adjustments to their diet in preparation for surgery.

After the laparoscopic colectomy:

  1. Patient undergoes the laparoscopic colectomy procedure, either LARC or TLRC.
  2. Patient is monitored in the recovery room for a period of time before being transferred to a hospital room.
  3. Patient may experience some pain and discomfort following the surgery, but this is managed with pain medication.
  4. Patient is encouraged to start moving and walking as soon as possible to prevent complications such as blood clots.
  5. Patient is gradually allowed to start drinking clear liquids and then advance to a regular diet as tolerated.
  6. Patient may be discharged from the hospital once they are able to tolerate food, have normal bowel function, and their pain is well controlled.
  7. Patient will have follow-up appointments with their surgical team to monitor their recovery and discuss any concerns or questions.

What to Ask Your Doctor

  1. What are the potential benefits of undergoing a totally laparoscopic right colectomy (TLRC) compared to laparoscopy-assisted right colectomy (LARC)?

  2. What are the potential risks or disadvantages of choosing TLRC over LARC for right colon cancer surgery?

  3. How experienced are you in performing totally laparoscopic right colectomies?

  4. How long does the surgery typically take and what is the expected recovery time for TLRC compared to LARC?

  5. What can I expect in terms of pain management and postoperative care following a TLRC procedure?

  6. Are there any specific factors about my individual case that may make me a better candidate for TLRC or LARC?

  7. How will my surgical incisions look after the procedure and what is the likelihood of scarring with TLRC versus LARC?

  8. Are there any long-term implications or differences in outcomes between TLRC and LARC that I should be aware of?

  9. Will there be any changes in my diet or lifestyle following a TLRC procedure compared to LARC?

  10. Are there any additional follow-up appointments or monitoring that I should expect after undergoing a totally laparoscopic right colectomy?

Reference

Authors: Zhang M, Lu Z, Zheng Z, Cheng P, Zhou H, Wang X. Journal: Surg Endosc. 2022 Jan;36(1):176-184. doi: 10.1007/s00464-020-08252-6. Epub 2021 Jan 11. PMID: 33427910