Luca Maria Siani1, Andrea Lucchi2, Pierluigi Berti2, Gianluca Garulli2. 1. General, Thoracic and Minimally Invasive Surgery Unit, Azienda Unica della Romagna, Ceccarini Hospital, Riccione, Italy. Electronic address: lucamaria.siani@gmail.com. 2. General, Thoracic and Minimally Invasive Surgery Unit, Azienda Unica della Romagna, Ceccarini Hospital, Riccione, Italy.
Abstract
BACKGROUND: To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS: 600 consecutive patients were studied. RESULTS: Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 mm and mean lymph nodes harvested was 27 ± 3; mesocolic plane was achieved in 81% of cases. Survival was 83%; stratified survival in patients with stage II, IIIA/B and in the subgroup of stage IIIC patients with negative apical nodes was 88.7%, 72.4%, 71.4% respectively; stage IIIC patients with positive apical nodes showed poor survival (27.7%). Recurrence occurred in 177 patients (29.5%) and was mainly systemic (22.7%). At the multivariate analysis, "non mesocolic" plane of resection, positive N3 apical nodes and CEA levels >5 ng/dL were found to be independent prognostic factors. CONCLUSIONS: Laparoscopic right Mesocolectomy showed to be safe and yielded surgical specimens of high quality, with impact on survival; positive N3 apical nodes and "non mesocolic" planes were independently associated to poor outcome.
BACKGROUND: To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS: 600 consecutive patients were studied. RESULTS: Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 mm and mean lymph nodes harvested was 27 ± 3; mesocolic plane was achieved in 81% of cases. Survival was 83%; stratified survival in patients with stage II, IIIA/B and in the subgroup of stage IIIC patients with negative apical nodes was 88.7%, 72.4%, 71.4% respectively; stage IIIC patients with positive apical nodes showed poor survival (27.7%). Recurrence occurred in 177 patients (29.5%) and was mainly systemic (22.7%). At the multivariate analysis, "non mesocolic" plane of resection, positive N3 apical nodes and CEA levels >5 ng/dL were found to be independent prognostic factors. CONCLUSIONS: Laparoscopic right Mesocolectomy showed to be safe and yielded surgical specimens of high quality, with impact on survival; positive N3 apical nodes and "non mesocolic" planes were independently associated to poor outcome.
Authors: José Tomás Larach; Julie Flynn; Timothy Wright; Amrish K S Rajkomar; Jacob J McCormick; Joseph Kong; Philip J Smart; Alexander G Heriot; Satish K Warrier Journal: Surg Endosc Date: 2021-04-12 Impact factor: 4.584
Authors: M Franceschilli; D Vinci; S Di Carlo; B Sensi; L Siragusa; A Guida; P Rossi; V Bellato; R Caronna; S Sibio Journal: Discov Oncol Date: 2021-08-06