Literature DB >> 24986011

Laparoscopic complete mesocolic excision with radical lymph node dissection along the surgical trunk for right colon cancer.

Shinichiro Mori1, Kenji Baba, Masayuki Yanagi, Yoshiaki Kita, Shigehiro Yanagita, Yasuto Uchikado, Takaaki Arigami, Yoshikazu Uenosono, Hiroshi Okumura, Akihiro Nakajo, Kosei Maemuras, Sumiya Ishigami, Shoji Natsugoe.   

Abstract

BACKGROUND: We have evaluated the safety and feasibility of combining median-to-lateral and anterior-to-median (MLAM) approaches to perform laparoscopic complete mesocolic excision (CME) with radical lymph node dissection along the gastrocolic trunk of Henle (GTH) for right hemicolon cancer. PATIENTS AND METHODS: We retrospectively analyzed data obtained from a prospectively maintained database on 31 consecutive patients who had undergone laparoscopic CME with radical lymph node dissection for right hemicolon cancer between January 2010 and December 2013. We used video recordings of the procedure to assess the quality of the surgery and completeness of CME. We also assessed operative data, pathological findings, length of large bowel resected, complications, BMI, operative time by experience of surgeon, and length of hospital stay.
RESULTS: All patients had undergone en bloc resection of the enveloped parietal planes and radical lymph node dissection along the surgical trunk without any serious intraoperative complications. Twenty six and five patients graded mesocolic and intra-mesocolic plane, respectively. Five, three, eleven, and thirteen patients had T1, T2, T3, and T4 tumors, respectively. The median number of lymph nodes retrieved was 25, lymph node metastasis being identified in 11 patients. The mean length of large bowel resected was 21.8 cm. The mean operative time and intraoperative blood loss were 269 min and 39 mL, respectively. No intraoperative complications occurred in any patient. Three patients had postoperative complications. The mean BMI was 22.6 kg/m(2). The mean operative time for patients stratified by BMI of <22 or ≥22 was 225 and 297 min, respectively. There were no correlations with operative time by experience of surgeon. The median postoperative hospital stay was 13 days.
CONCLUSIONS: Laparoscopic CME conducted by fusion fascia exposure with radical lymph node dissection along the GTH via a combination of MLAM approaches is a safe and feasible procedure for right hemicolon cancer.

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Year:  2014        PMID: 24986011     DOI: 10.1007/s00464-014-3650-3

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  29 in total

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2.  Laparoscopic versus open surgery for rectal cancer: long-term oncologic results.

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4.  Completely medial versus hybrid medial approach for laparoscopic complete mesocolic excision in right hemicolon cancer.

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5.  Laparoscopic complete mesocolic excision (CME) with medial access for right-hemi colon cancer: feasibility and technical strategies.

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7.  Clinical significance of lymph node ratio and location of nodal involvement in patients with right colon cancer.

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9.  Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial.

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2.  "Top down no-touch" technique in robotic complete mesocolic excision for extended right hemicolectomy with intracorporeal anastomosis.

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Review 4.  Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer: A comprehensive review.

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5.  Laparoscopic complete mesocolic excision via mesofascial separation for left-sided colon cancer.

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6.  Complete mesocolic excision: Techniques and outcomes.

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7.  Hand-assisted laparoscopic right hemicolectomy with complete mesocolic excision and central vascular ligation: a novel technique for right colon cancer.

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8.  Reduced port versus open right hemicolectomy for colorectal cancer: a retrospective comparison study of two centers.

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9.  Laparoscopic complete mesocolic excision via combined medial and cranial approaches for transverse colon cancer.

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Review 10.  Surgery along the embryological planes for colon cancer: a systematic review of complete mesocolic excision.

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