Laparoscopic-Assisted Versus Open Complete Mesocolic Excision and Central Vascular Ligation for Right-Sided Colon Cancer

Abstract

Herein, we demonstrated the feasibility and safety of LCME for right-sided colon cancer, and in terms of better short-term outcomes, LCME was more advantageous than OCME. Although LCME for right-sided colon cancer was associated with better 5-year overall survival, compared with an open approach, the long-term oncologic outcomes between the groups were comparable.

Short-Term and Long-Term Outcomes of Complete Mesocolic Excision with Central Vascular Ligation for Ascending Colon Cancer: Single Institution

“…The mean operation time in the present study was found to191.6min. The means of the length of hospital stay (13.9 days), time to sips of water (4.7 days), time to soft diet (7.7 days), and blood loss (85.6 ml) in the present study were similar to those reported in previous studies [18][19][20][21]. Specimens were collected most often from the correct anatomical plane in colon cancer resection (92% vs. 40%, p<0.0001) and had a higher number of harvested lymph nodes (30 vs. 18, p<0.0001) than non-CME specimens [7].…”

“…The most commonly occurring complications were found to be ileus and wound dehiscence. The mean operation time of CME in previous studies ranged from 136-269 min, and no significant differences were reported between open and laparoscopic surgeries [21,22]. The mean operation time in the present study was found to191.6min.…”

“…Specimens were collected most often from the correct anatomical plane in colon cancer resection (92% vs. 40%, p<0.0001) and had a higher number of harvested lymph nodes (30 vs. 18, p<0.0001) than non-CME specimens [7]. Several studies reported that the mean number of harvested lymph nodes in CME with CVL for right colon cancer ranged from 28-35.4 for open CME and 19-34.4 for laparoscopic CME [21][22][23][24]. The mean number of harvested lymph nodes in the present study was 30.3.…”

Laparoscopic caudal-to-cranial approach for radical lymph node dissection in right hemicolectomy

“…A retrospective study with 399 patients analyzing the correlation between surgical quality and prognosis found that improving the plane of dissection might improve survival, especially in patients with stage III disease [20]. Bae et al [22] studied 263 patients undergoing CME for right-sided colon cancer to explore the safety and feasibility of laparoscopic CME (LCME) and to compare oncologic outcomes between LCME and open CME (OCME). They confirmed the feasibility and safety of LCME for right-sided colon cancer, and in terms of better short-term outcomes, LCME was more advantageous than OCME.…”

Right Colectomy with Complete Mesocolic Excision: Four-arm Technique

“…To date and to the best of our knowledge, few reports analyzing the safety and feasibility of laparoscopic CME for right-sided colonic malignancies exist in the literature [7][8][9][10][11][12][13][14]. No studies have focused selectively on the robotic approach.…”