Medial versus lateral approache in laparscopic right hemicolectomy
DOI:
https://doi.org/10.18203/2349-2902.isj20192942Keywords:
LA, Laparscopic RT hemicolectomy, MAAbstract
Background: Approach to right colon cancer is through open exploration but it has many complication, now laparoscopic right hemicolectomy is an advanced cancer surgery, laparoscopic right hemicolectomy can be done by medial or lateral or combined approach.
Methods: This is prospective study carried out on 30 patients admitted to department of surgery in menufia university hospital from September 2016 to September 2018 and all cases have RT colon cancer; The patients are divided into three groups, 1- group A (n=10): underwent medial approach for laparscopic right hemicolectomy 2- group B (n=10): underwent lateral approach for laparscopic right hemicolectomy, 3- group C (n=10) : underwent combined laparscopic medial and lateral approach, Blood loss, operative time, operative and postoperative complication were assessed. The period of follow up is for 6 months.
Results: Operative duration and blood loss were significantly lower in combined approach. Intra and post operative complications were low in combined and MA.
Conclusions: Laparoscopic combined approach reduces the operative time and blood loss than MA and LA. Besides the oncologic advantages of an early vessel division and a "no-touch" dissection.
References
Ibrahim AS, Khaled HM, Mikhail NN, Baraka H, Kamel H. Cancer incidence in Egypt: results of the national population-based cancer registry program. J Cancer Epidemiol. 2014;2014.
Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, et al. Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study. 2013.2016, BMJ: i3857.
Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. "Sedentary Time and Its Association with Risk for Disease Incidence, Mortality, and Hospitalization in Adults: A Systematic Review and Meta-analysis". Annals of Internal Medicine. 2015;162(2):123-32.
Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: A randomised trial. Lancet. 2012;359:2224–9.
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, et al. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87-108.
Kahokehr A, Zargar-Shoshtari K, Srinivasa S, Hill AG. Recovery after open and laparoscopic right hemicolectomy: A comparison. J Surg Res. 2010; 162:11-6.
Kim SJ, Ryu GO, Choi BJ, Kim JG, Lee KJ, Lee SC, et al. The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg. 2018;254(6):933-40.
Pingping Xu Xu P, Ren L, Zhu D, Lin Q, Zhong Y, et al. Open Right Hemicolectomy: Lateral to Medial or Medial to Lateral Approach? PLoS ONE 2015;10(12):e0145175.
Zhao GL, Chen Y . Clinical efficacy of laparoscopic complete mesoreclalexcisionwith a medial-to-lateral approach for right colonic cancer. Chin J Dig Surg. 2014;13:645–7.
Ding J, Liao GQ, Xia Y, Zhang ZM, Pan Y, Liu S, Zhang Y, Yan ZS. Medial versus lateral approach in laparoscopic colorectal resection: a systematic review and meta-analysis World J. Surg. 2013;37 (4):863-872.
Pigazzi A, Hellan M, Ewing DR, Paz BI, Ballantyne GH. Laparoscopic medial-to-lateral colon dissection: how and why. J Gastrointest Surg. 2007;11:778-82.
Ballantyne GH, Ewing D, Pigazzi A, Wasielewski A. Telerobotic-assisted laparoscopic right hemicolectomy: lateral to medial or medial to lateral dissection? Surg Laparosc Endosc Percutan Tech. 2006;16:406-10.
Yan J, Ying MG, Zhonghua Wei, Chang Wai Ke Za. A prospective randomized control trial of the approach for laparoscopic right hemi-colectomy:medial-to-lateral versus lateral-to-medial. 2010;13:403-5.
Tang W, Xiao Y, Qiu HZ, Wu B, Sun XY. Outcome of laparoscopic radical right hemicolectomy with complete mesocolic resection and D3 lymphadenectomy. Chin J Surg. 2015;52:249–53.
Huscher CG, Mingoli A, Sgarzini G, Mereu A, Binda B, Brachini G, et al.Standard laparoscopic versus single-incision laparoscopic colectomy for cancer. 2012;30:256–9.
Kang J, Kim IK, Kang SI, Sohn SK, Lee KY. Laparoscopic right hemicolectomy with complete mesocolic excision. Surg Endosc. 2014;28:2747-51.
Adamina M, Manwaring ML, Park KJ, Delaney CP. Laparoscopic complete mesocolic excision for right colon cancer. Surg Endosc. 2012;26:2976–80.
Ignjatovic D, Spasojevic M, Stimec B. Can the gastrocolic trunk of Henle serve as an anatomical landmark in laparoscopic right colectomy? A postmortem anatomical study. Am J Surg. 2010; 199:249-54.
Wang Y, Zhang C, Zhang D, Fu Z, Sun YM. Comparison of short-term outcomes between laparoscopic-assisted and open complete mesocolic excision (CME) for the treatment of transverse colon cancer. World J Surgical Oncol. 2017;15:174.
Xu P, Zhu D, Ren L, Lin Q, Zhong Y, Tang W, et al. Open right hemicolectomy: lateral to medial or medial to lateral approach? PLoS One 2015; 10:e0145175.
Senagore AJ, Duepree HJ, Delaney CP, Brady KM, Fazio VW. Results of a standardized technique and postoperative care plan for laparoscopic sigmoid colectomy: a 30-month experience. Dis Colon Rectum. 2003;46:503-09.
Veldkamp R. Abraham NS, Young JM, Solomon MJ. Laparoscopic resection of colon cancer: consensus of the European association of endoscopic surgery (EAES). Surg Endosc. 2004;18(8):1163-85.
Melich G, Jeong DH, Hur H, Baik SH, Faria J, Kim NK, et al. Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is lengthy-analysis of learning curves for a novice minimally invasive surgeon. Canadian J Surg. 2014;57(5):331.
West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P; 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; 28:272-8.
Zhu D, Xu P, Ren L, Lin Q, Zhong Y, Tang W, et al. Open right hemicolectomy: lateral to medial or medial to lateral approach? PLoS One. 2015;10:e0145175.
Le Voyer TE, Sigurdson ER, Hanlon AL, Mayer RJ, Macdonald JS, et al. Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol. 2003;21:2912-9.
Chang GJ, Rodriguez-Bigas MA, Skibber JM, Moyer VA. Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst. 2007; 99:433-41.
Poon JT, Liang JT, Lai HS, Lee PH. Impact of the standardized medial-to-lateral approach on outcome of laparoscopic colorectal resection World J Surg. 2009;33(10):2177-82.
Dayn W, Lau PY. Impact of the standardized medial-to-lateral approach on outcome of laparoscopic colorectal resection. is it a fair comparison? World J Surg. 2010;34(5):1146-7.
