Ik Yong Kim1, Bo Ra Kim2, Eun Hee Choi3, Young Wan Kim4. 1. Department of Surgery, Division of Gastrointestinal Surgery, Yonsei University Wonju College of Medicine, Wonju, South Korea. 2. Department of Internal Medicine, Division of Gastroenterology, Yonsei University Wonju College of Medicine, Wonju, South Korea. 3. Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea. 4. Department of Surgery, Division of Gastrointestinal Surgery, Yonsei University Wonju College of Medicine, Wonju, South Korea. Electronic address: youngwkim@yonsei.ac.kr.
Abstract
PURPOSE: To evaluate the pathologic, short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision (CME) and central ligation for right-sided colon cancer. METHODS: All patients (n = 215) underwent elective CME either by open surgery (n = 99) or laparoscopy (n = 116). RESULTS: Mean number of retrieved lymph nodes (31 vs. 27, p = 0.012) was greater in the open CME group. Between the open and laparoscopic CME groups, there were no differences of length of the specimen (44.3 cm and 43.2 cm), ileum (14 cm and 13.3 cm), or colon (30.3 cm and 29.8 cm), respectively. Proximal and distal margins were similar. Mean operative time was similar between the open and laparoscopic CME groups (175 min vs. 178 min). The rate of 30-day postoperative complications (36.4% vs. 23.3%, p = 0.036) was higher in the open CME group. There were no differences in 3-year overall survival rates (86.9% vs. 95.5% in stage II disease and 70.2% vs. 90.7% in stage III disease) or recurrence-free survival rates (84.5% vs. 84.8% in stage II disease and 64.2% vs. 68.9% in stage III disease) between the open and laparoscopic CME groups. CONCLUSIONS: Pathologic (specimen lengths, resection margin lengths, number of lymph nodes, and R0 resection) and oncologic outcomes of the laparoscopic CME group were comparable. Moreover, laparoscopic CME conferred short-term benefits in terms of lower rates of postoperative complications, reduced time to soft diet, and reduced length of hospital stay. Based on these results, laparoscopic CME can be considered as a routine elective approach for right-sided colon cancer.
PURPOSE: To evaluate the pathologic, short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision (CME) and central ligation for right-sided colon cancer. METHODS: All patients (n = 215) underwent elective CME either by open surgery (n = 99) or laparoscopy (n = 116). RESULTS: Mean number of retrieved lymph nodes (31 vs. 27, p = 0.012) was greater in the open CME group. Between the open and laparoscopic CME groups, there were no differences of length of the specimen (44.3 cm and 43.2 cm), ileum (14 cm and 13.3 cm), or colon (30.3 cm and 29.8 cm), respectively. Proximal and distal margins were similar. Mean operative time was similar between the open and laparoscopic CME groups (175 min vs. 178 min). The rate of 30-day postoperative complications (36.4% vs. 23.3%, p = 0.036) was higher in the open CME group. There were no differences in 3-year overall survival rates (86.9% vs. 95.5% in stage II disease and 70.2% vs. 90.7% in stage III disease) or recurrence-free survival rates (84.5% vs. 84.8% in stage II disease and 64.2% vs. 68.9% in stage III disease) between the open and laparoscopic CME groups. CONCLUSIONS: Pathologic (specimen lengths, resection margin lengths, number of lymph nodes, and R0 resection) and oncologic outcomes of the laparoscopic CME group were comparable. Moreover, laparoscopic CME conferred short-term benefits in terms of lower rates of postoperative complications, reduced time to soft diet, and reduced length of hospital stay. Based on these results, laparoscopic CME can be considered as a routine elective approach for right-sided colon cancer.
Authors: Peter Tschann; Gerald Seitinger; Daniel Lechner; Stephanie Adler; Benedikt Feurstein; Paolo N C Girotti; Theresa Schmölzer; Philipp Szeverinski; Felix Aigner; Ingmar Königsrainer Journal: Int J Colorectal Dis Date: 2021-04-06 Impact factor: 2.571
Authors: Giuseppe S Sica; Danilo Vinci; Leandro Siragusa; Bruno Sensi; Andrea M Guida; Vittoria Bellato; Álvaro García-Granero; Gianluca Pellino Journal: Surg Endosc Date: 2022-09-12 Impact factor: 3.453