Laparoscopic versus open complete mesocolic excision with central vascular ligation in right colon cancer

Abstract

Background: The purpose of this study was to compare between laparoscopic and open complete mesocolic excision (CME) with central vascular ligation (CVL) in right colon cancer.Methods: From January 2016 to December 2018, a prospective cohort study of 60 patients who diagnosed as operable right sided colon cancer was performed. The patients were classified into laparoscopic CME with CVL and open CME with CVL groups. Demographic variables, comorbidities, tumor location, intraoperative parameters, duration of hospital study, histopathological findings, postoperative complications and follow up data were compared between the two groups. Demographic variables included age and sex distribution. Intraoperative parameters included incision length, operative time and operative blood loss.Results: 60 patients were selected in this study. Both groups were the same in the age and sex distribution, potential comorbidities and tumor location. Patients in the Laparoscopic CME with CVL group had shorter incision lengths, longer operative times, less operative blood loss, shorter hospital stay, less number of retrieved lymph nodes , the same TNM (tumor nodes metastasis) classifications, similar histopathological findings and comparable incidence of postoperative complications.Conclusions: Laparoscopic CME with CVL procedure is a safe, valid and feasible surgical method for right colon cancers.

A global systematic review and meta-analysis on laparoscopic vs open right hemicolectomy with complete mesocolic excision

“…After screening of titles and abstracts, 36 studies were analysed in full text, with 12 studies excluded as reported in SDC1, leaving 23 studies matching the inclusion criteria for meta-analysis [ 13 – 47 ], one PhD thesis by El Nakeeb (not published) [ 13 ]. Of these, two references [ 15 , 16 ] report the same data as well as the PhD thesis [ 13 ]. In addition, we found one ongoing study (registered in ClinicalTrials.gov as NCT03826446) [ 48 ].…”

“…Local recurrence at 3 years was reported in 3 studies [ 14 , 16 , 24 ] ( n = 414). The overall incidence of local recurrence was significantly lower in the laparoscopic group (RR 0.60, 95% CI 0.38 to 0.95, P = 0.03, I 2 = 0%) (SDC 7).…”

“…There were one RCT, performed at Menoufia University (Egypt) [15,16] and 20 CCTs [14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Sixteen studies were performed in Asia (4601 patients, 91.3%), including 13 from China (2158 patients), 2 from South Korea (2419 patients) and 1 from Bangladesh (24 patients).…”

“…Nine studies [16,19,21,22,24,27,[31][32][33] reported postoperative mortality at 30 days (n = 2471). No statistically significant difference was observed between the two groups (RR 0.53, 95% CI 0.13-2.11, P = 0.37, I 2 = 0%) (SDC 11).…”

Outcomes of laparoscopic assisted versus open complete mesocolic excision for right sided colon cancer

“…sided colon cancer during the follow-up period of 24 months regarding tumor recurrence, metastasis or cancer-related deaths in both groups. 27 On the opposite side, Lacy et al showed that the 5-year overall survival of patients with stage III disease was significantly better after lap. surgery.…”