Comparison Of Conventional Access Routes For Right Hemicolectomy In Colon Cancerdata From The Dgav Studoq Registry

BackgroundAccess 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.MethodsPatients 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).ResultsA 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.ConclusionsFor oncological right hemicolectomy, open transverse upper abdominal laparotomy appears to be superior to median laparotomy in short-term course.