Oncologic Outcome of Stages II/III Colon Cancer Treated via Minilaparotomy

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We performed a retrospective review of non-overweight (body mass index ≤ 25 kg/m(2)) patients scheduled to undergo a curative resection of locally advanced colon cancer via a transverse mini-incision (n = 62) or a longitudinal mini-incision (skin incision ≤7 cm, n = 62), with the latter group of patients randomly selected as historical controls matched with the former group according to tumor location. Extension of the transverse mini-incision wound was necessary in 3 patients (5%). Both groups were largely equivalent in terms of demographic, clinicopathological, and surgical factors and frequency of postoperative complications. Postoperative analgesic was significantly less (P = 0.04) and postoperative length of the hospital stay was significantly shorter (P < 0.01) in the transverse mini-incision group. Concerning a mini-incision approach for locally advanced colonic cancer, a transverse incision seems to be advantageous with regard to minimal invasiveness and early recovery compared with a longitudinal incision.

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniques Via Transverse Mini-incisionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison Between Transverse Mini-Incision and Longitudinal Mini-Incision for the Resection of Locally Advanced Colonic Cancer

Ishida

Sobajima

Yokoyama

et al. 2014

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“…We have performed curative colectomy for colon cancer using an ML (skin incision, ,7 cm) as the surgical approach of first choice since September 2000. 8,15,16 Based on this abundant experience, we have come to think of distal gastrectomy via ML as an original procedure. In addition, as laparoscopy is useful to perform lymph node dissection and exfoliation through a small incision, we have gradually and naturally evolved from a pure ML to MLLA.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Different Minimally Invasive Procedures of Distal Gastrectomy for Nonoverweight Patients with T1N0-1 Gastric Cancer

Haga

Ishiguro

Kuwabara

et al. 2013

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Laparoscopic-assisted distal gastrectomy has recently come to be a standard procedure for the treatment of early gastric cancer 1-5 in select patients. The minimal invasiveness associated with laparoscopic procedures for the resection of gastrointestinal cancer has been repeatedly explained in part by the short incision that is required. 6-11 We used two different approaches to perform distal gastrectomies for the resection of gastric cancer as minimally invasive alternatives to a standard laparoscopic approach prior to our surgical team's complete mastery of the skills required for laparoscopic oncological surgery for gastric cancer. 9,12 If the minimal invasiveness associated with laparoscopic-assisted gastrectomy can be explained by the small incision, a gastrectomy via a small incision without the use of a pneumoperitoneum may provide a similar outcome in patients. However, to our knowledge, such a comparison has not been previously made. We compared the minimal invasiveness of three different approaches (minilaparotomy, minilaparotomy approach with laparoscopic assistance, and standard laparoscopicassisted approach) to performing a distal gastrectomy for T1N0-1 gastric cancer in nonoverweight patients (body mass index, 25 kg/m 2 ) performed within a limited study period.

“…The subjects were 215 Japanese patients (127 men and 88 women) who underwent right (hemi) colectomy with standard lymph node dissection for right colon cancer through a conventional open or minilaparotomy approach [5][6][7] at our hospital between January 1999 and September 2009. The standard lymph node dissection included removal of the epicolic, paracolic, intermediate, and main lymph nodes, corresponding to D3-level lymph node dissection according to the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum, and Anus in Japan.…”

Section: Methodsmentioning

confidence: 99%

Three-Dimensional Vascular Anatomy Relevant to Oncologic Resection of Right Colon Cancer

Tajima

Ishida

Ohsawa

et al. 2011

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We analyzed data on the three-dimensional vascular anatomy of the right colon from the operative documents of 215 patients undergoing oncologic resection for right colon cancer. The right colic artery (RCA) was absent in 146 patients (67.9%), with the ileocolic artery (ICA) crossing the superior mesenteric vein (SMV) ventrally in 78 patients (36.3%). When the RCA was present, both the ICA and the RCA crossed the SMV ventrally in 44 patients (20.5%), dorsally in 10 patients (4.7%), the RCA crossed the SMV ventrally and the ICA dorsally in 10 patients (4.7%), and the RCA crossed the SMV dorsally and the ICA ventrally in 5 patients (2.2%). The arterial branches toward the hepatic flexure crossed the SMV ventrally in 151 eligible cases: the branch originated from the common trunk of the middle colic artery in 97 patients (64.2%) and 1 and 2 arteries directly originated from the SMA in 49 patients (32.5%) and in 5 patients (3.3%), respectively. These data would be useful to safely perform lymph node dissection around the SMV.Key words: Superior mesenteric artery -Superior mesenteric vein -Colon cancerLymphadenectomy -Colectomy B ecause the superior mesenteric artery (SMA) is located mostly on the left side of the superior mesenteric vein (SMV), the branches originating directly from the SMA, such as the ileocolic artery (ICA), the right colic artery (RCA), and the middle colic artery (MCA), cross the SMV ventrally or dorsally. Familiarity with the three-dimensional relations of these arteries and the SMV would enable safer and easier performance of oncologic resection for right colon cancer. However, because Patients and MethodsThe subjects were 215 Japanese patients (127 men and 88 women) who underwent right (hemi) colectomy with standard lymph node dissection for right colon cancer through a conventional open or minilaparotomy approach 5-7 at our hospital between January 1999 and September 2009. The standard lymph node dissection included removal of the epicolic, paracolic, intermediate, and main lymph nodes, corresponding to D3-level lymph node dissection according to the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum, and Anus in Japan.8 Cancers of the right colon was defined as located in the cecum, ascending colon, or hepatic flexure. The median age of the patients was 68 years (range, 34-92 years). The tumors were classified according to the TNM classification 9 as stage I in 32 patients (14.9%), stage II in 90 patients (41.9%), stage III cases in 76 patients (35.3%), and stage IV in 17 patients (7.9%). In the present series, standard lymph node dissection was also performed in selected patients with stage IV disease in combination with synchronous resection of a hepatic metastasis, or in patients who were candidates for hepatic and/or pulmonary metastatectomy after effective chemotherapy. We retrospectively analyzed the three-dimensional relations of the arteries directly originating from the SMA with the SMV based on operative findings that were prospectively recorded by ...