الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This prospective randomized study included 66 cases who underwent right hemicolectomy with complete mesocolic excision during the period July, 2017 till January, 2019 in Gastrointestinal Surgical center, Mansoura University, Egypt.These patients were subdivided into two groups: 33 cases underwent the open approach while the remaining 33 cases were performed laparoscopically. Despite the variability in their preoperative data, only BMI showed to be significantly higher in the laparoscopic group (p< 0.0001).Preoperative evaluation of patients was performed. The workup included history taking, clinical examination, detailed laboratory workup comprising chemical and haematological studies. Imaging studies like triphasic CT, contrast enema, abdominal ultrasound were used in the evaluation in addition to colonoscopy and biopsy. Intraoperatively, the laparoscopic group showed some cons like total operative time (p = 0.001) and time needed for dissection (p < 0.001) which were significantly higher when compared to the open group. In the postoperative period, close monitoring of all clinical and laboratory parameters was performed with bedside imaging by US in indicated cases. The laparoscopic group took the upper hand over open group regarding day of first motion, when to start oral intake and hospital stay (p = <0.001, <0.001 and 0.002 respectively).When analysing surgical specimen of both groups, Not only did the laparoscopic group have a longer specimen (p =0.009), but also it was evident that this group has a longer distance between the normal colon and the central vascular tie (p = 0.007). There were no significant variables when comparing laparoscopic and open groups as regard specimen pathology, mass size, length of proximal safety margin, length of distal safety margin, number of harvested lymph nodes (p > 0.05).It was evident from our study that the laparoscopic approach for right hemicolectomy with complete mesocolic excision has some advantages over the open approach especially regarding post-operative course and pathological outcome. The disadvantage concerned with long operative time can be handled over time, as the more operations to be done, the higher learning curve the surgeon will achieve and of course, a less operative time.Our recommendation is to start with laparoscopic approach in management of right colon cancer with CVL and CME techniques.Further studies should be done about this subject as the long-term oncological outcome, presented as disease free survival and overall survival, should be handled with more concentration. Reporting and sharing knowledge about the value of surgical dissection along surgical planes and complete lymphatic clearance with laparoscopic approach to the colorectal community in order to improve the overall results and help surgeons to make knowledge-based decisions.