A New Medial-to-Lateral Approach for Laparoscopic D3 Lymphadenectomy plus Complete Mesocolic Excision (D3 + CME) for Right-Sided Colon Cancer

Luo, Wenjun; Lu, Tingting; Xiao, Yanling; Li, Fugen; Xu, Zhengwen; Jia, Yongsheng

doi:10.1245/s10434-020-09264-1

Cited by 9 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, few studies compared other approaches in laparoscopic colorectal surgery, although the advantages of each approach have been emphasized [14,15,17,25]. Of note, the long-term outcomes of laparoscopic surgery for right-sided colon cancer have not yet been compared between each approach.…”

Section: Discussion and Con Clus Ionsmentioning

confidence: 99%

“…With regard to the long‐term outcomes, only one study of rectosigmoid cancer in the meta‐analysis gave data on recurrence rate, noting no significant difference between the two groups [16]. However, few studies compared other approaches in laparoscopic colorectal surgery, although the advantages of each approach have been emphasized [14, 15, 17, 25]. Of note, the long‐term outcomes of laparoscopic surgery for right‐sided colon cancer have not yet been compared between each approach.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Inferior versus medial approach in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer: A propensity‐score‐matched analysis

et al. 2022

View full text Add to dashboard Cite

Aim In laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer, either an inferior approach (IA) or a medial approach (MA) is selected in our institution based on the surgeon's preference. The present study compared the treatment outcomes between IA and MA. Method This retrospective, single‐centre study using propensity score matching analysed the short‐ and long‐term outcomes of laparoscopic surgery in patients with right‐sided colon cancer from 2010 to 2019 at Cancer Institute Hospital. Results After patient selection, 1011 patients remained for the analysis, of which 67% underwent IA surgery and 33% underwent MA surgery. After propensity score matching (1:1), 325 patients in each group were analysed. Regarding the short‐term outcomes, there were no significant differences in the operation time, rate of conversion to open surgery or postoperative complication rate (Clavien–Dindo Grade ≥ III) between the two groups, although the intra‐operative median blood loss was significantly less in the IA group than in the MA group (IA, 13 ml vs. MA, 20 ml, P < 0.0001). Regarding the long‐term outcomes, the relapse‐free survival, liver‐relapse‐free survival, cancer‐specific survival and overall survival were all similar between groups. Conclusion Both the IA and MA in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer are safe and feasible approaches; the IA may have an advantage over the MA in terms of reduced intra‐operative blood loss. Based on their similar oncological outcomes, either the IA or MA can be selected, based on one's preference.

show abstract

Section: Discussion and Con Clus Ionsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inferior versus medial approach in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer: A propensity‐score‐matched analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In recent years, various methods have been developed to accomplish laparoscopic right hemicolectomy. Currently, there is no high-level evidence in the literature to demonstrate the superiority of any one technique over another [3][4][5][6]. This report describes a new cranial-to-caudal approach combined with page-turning dissection in laparoscopic right hemicolectomy.…”

Section: Dear Sirmentioning

confidence: 92%

The page‐turning approach: A novel technique for laparoscopic right hemicolectomy with complete mesocolic excision

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Hence, there are still doubts as to whether CME with CVL can be safely performed in laparoscopic surgery. Since the approach for mesenteric dissection and CVL in laparoscopic surgery is different from that of open surgery, various laparoscopic surgical techniques have been devised like a bottom-up, cranial-caudal, or arterial first approach [41][42][43][44][45][46][47][48]. In a recent meta-analysis, laparoscopic CME had comparable outcomes in harvested lymph nodes, longitudinal bowel length, mesenteric area, and vertical margin to open CME.…”

Section: Compatibility Of Laparoscopic Cme With Cvlmentioning

confidence: 99%

Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?

Son

Lee

et al. 2021

Ann Coloproctol

View full text Add to dashboard Cite

Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

show abstract

A New Medial-to-Lateral Approach for Laparoscopic D3 Lymphadenectomy plus Complete Mesocolic Excision (D3 + CME) for Right-Sided Colon Cancer

Cited by 9 publications

References 5 publications

Inferior versus medial approach in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer: A propensity‐score‐matched analysis

Inferior versus medial approach in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer: A propensity‐score‐matched analysis

The page‐turning approach: A novel technique for laparoscopic right hemicolectomy with complete mesocolic excision

Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?

Contact Info

Product

Resources

About