Laparoscopic versus open complete mesocolic excision with central vascular ligation in right colon cancer
DOI:
https://doi.org/10.18203/2349-2902.isj20191871Keywords:
Right colon cancer, Mesocolic excisionAbstract
Background: The purpose of this study was to compare between laparoscopic and open complete mesocolic excision (CME) with central vascular ligation (CVL) in right colon cancer.
Methods: From January 2016 to December 2018, a prospective cohort study of 60 patients who diagnosed as operable right sided colon cancer was performed. The patients were classified into laparoscopic CME with CVL and open CME with CVL groups. Demographic variables, comorbidities, tumor location, intraoperative parameters, duration of hospital study, histopathological findings, postoperative complications and follow up data were compared between the two groups. Demographic variables included age and sex distribution. Intraoperative parameters included incision length, operative time and operative blood loss.
Results: 60 patients were selected in this study. Both groups were the same in the age and sex distribution, potential comorbidities and tumor location. Patients in the Laparoscopic CME with CVL group had shorter incision lengths, longer operative times, less operative blood loss, shorter hospital stay, less number of retrieved lymph nodes , the same TNM (tumor nodes metastasis) classifications, similar histopathological findings and comparable incidence of postoperative complications.
Conclusions: Laparoscopic CME with CVL procedure is a safe, valid and feasible surgical method for right colon cancers.
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References
Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, Brenner H, et al. Global Burden of Disease Cancer Collaboration, Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2017;3:524.
Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ. 2014;348:2467–8.
Croner RS, Ptok H, Merkel S, Hohenberger W. Implementing complete mesocolic excision for colon cancer – mission completed. De Gruyter 2018. DOI: https://doi.org/10.1515/iss-2017-0042.
Wolff BG, Wang JW. Right hemicolectomy for treatment of cancer: open technique. In: Fischer JE, Jones DB, Pomposelli FR, et al. (Eds.), Mastery of Surgery. Vol 2. Chap 161. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
Feng B, Zhang S, Yan X, Ma J, Sun J, Lu J, et al. Operational approaches for laparoscopic complete mesocolic excision in right hemicolon cancer. Ann Laparosc Endosc Surg. 2016;1:26.
Kahokehr A, Zargar-Shoshtari K, Srinivasa S, Srinivasa S, Hill AG. Recovery after open and laparoscopic right hemicolectomy: A comparison, J Surg. Res. 2010;162:11-6.
Stormark K, Søreide K, Søreide JA, Kvaløy JT, Pfeffer F, Eriksen MT, et al. Nationwide implementation of laparoscopic surgery for colon cancer: Short-term outcomes and long-term survival in a population-based cohort. Surg Endosc. 2016;30:4853-64.
Agha RA, Borrelli MR, Vella-Baldacchino M, Thavayogan R, Orgill DP. Strengthening the reporting of Cohort studies in surgery. International J Surg. 2017;46:198-202.
Adamina M, Manwaring ML, Park KJ, Delaney CP. Laparoscopic complete mesocolic excision for right colon cancer, Surg. Endosc. 2012;26:297680.
Bae SU, Saklani AP, Lim DR, Kim DW, Hur H, Min BS, et al. Laparoscopicassisted versus open complete mesocolic excision and central vascular ligation for right sided colon cancer. Ann Surg Oncol. 2016;21:228894.
Sheng Q, Pan Z, Chai J, Cheng X, Liu F, Wang J, et al. Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches. Ann Surg Treat Res. 2017;92(2):90-6.
Vendramini DL, Albuquerque MM, Schmidt EM, Rossi-Junior EE, Gerent W de A, Cunha VJ. Laparoscopic and open colorectal resections for colorectal cancer. Arq Bras Cir Dig. 2012;25(2):81–7.
Negoi I, Hostiuc S, Negoi RI, Beuran M. Laparoscopic vs open complete mesocolic excision with central vascular ligation for colon cancer: A systematic review and meta-analysis. World J Gastrointest Oncol. 2017;9(12):475-91.
Li T, Meng XL, Chen W. Safety and Short-term Efficacy of a Laparoscopic Complete Mesocolic Excision for the Surgical Treatment of Right Hemicolon Cancer. Clin Surg Res Commun. 2018;2(2):29-33.
Stergios K, Pergialiotis V, Frountzas M, Nalwaya P, Kontzoglou K, Mohapatra SD. Laparoscopic Versus Open Colectomies: Enhanced Surgical Skills And Rigorous Patient Selection May Improve Operative Times Without Compromising Outcomes. J Surg. 2017;4(3).
Huang JL, Wei HB, Fang J, Zheng ZH, Chen TF, Wei B, et al. Comparison of laparoscopic versus open complete mesocolic excision for right colon cancer. International J Surg. 2015;23:12-7.
Kang J, Kim IK, Kang SI, Sohn SK, Lee KY. Laparoscopic right hemicolectomy with complete mesocolic excision. Surg Endosc. 2014;28:274751.
West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 2010;28(2):2728.
Chen Z, Sheng Q, Ying X, Chen W. Comparison of laparoscopic versus open complete mesocolic excision in elderly patients with right hemicolon cancer: retrospective analysis of one single cancer. Int J Clin Exp Med. 2017;10(3):5116-24.