Totally laparoscopic right colectomy with complete mesocolon excision

Lucchi, Andrea; Berti, Pierluigi; Gabbianelli, Carlo; Alagna, Vincenzo; Guerra, Mercedes; Vitolo, Giuliana; Vandi, F; Garulli, Gianluca

doi:10.1016/j.ejso.2018.01.049

Cited by 2 publications

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“…There were more patients with right colon cancer in the control group although not statistically significant (p = 0.761). The percentage of patients per ASA scores (1,2,3,4) were comparable between the two groups (p = 0.279).…”

Section: General Datamentioning

confidence: 87%

“…Colorectal cancer (CRC) has rapidly increased and has become the third most commonly diagnosed type of cancer and second leading cause of death worldwide [1]. Surgery remains the standard treatment for colon cancer with curative intent, and recently, totally laparoscopic surgery for colon cancer with intracorporeal anastomosis has been expected to be less invasive, with earlier postoperative recovery and lower complication rates [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer

Bao

et al. 2020

BMC Surg

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Background: To retrospectively evaluate the feasibility and safety of intraoperative assessment of bowel perfusion in totally laparoscopic surgery for colon cancer using indocyanine green fluorescence imaging (IGFI). Methods: From October 2017 to June 2019, consecutive patients with colon cancer who underwent totally laparoscopic surgery were enrolled retrospectively and grouped into the IGFI group (n = 84) and control group (n = 105). In the IGFI group, indocyanine green (ICG) was injected intravenously, and the bowel perfusion was observed using a fluorescence camera system prior to and after completion of the anastomosis. Results: The two groups were demographically comparable. The IGFI group exhibited a significantly shorter operative time (p = 0.0374) while intraoperative blood loss did not significantly differ among the groups (p = 0.062). In the IGFI group, average time to perfusion fluorescence was 48.4 ± 14.0 s after ICG injection, and four patients (4.8%) were required to choose a more proximal point of resection due to the lack of adequate fluorescence at the point previously selected. There were no differences in terms of pathological outcomes, postoperative recovery and the postoperative complication rates between the groups (p>0.05). Conclusion: IGFI shows promise as a safe and feasible tool to assess bowel perfusion during a totally laparoscopic surgery for colon cancer and may reduce the operative time.

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Section: General Datamentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer

Bao

et al. 2020

BMC Surg

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

Anania

Arezzo

Davies

et al. 2021

Int J Colorectal Dis

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Purpose The aim of this study was to compare the outcomes of right hemicolectomy with CME performed with laparoscopic and open surgery. Methods PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, Wanfang Data, Google Scholar and the ClinicalTrials.gov register were searched. Primary outcome was the overall number of harvested lymph nodes. Secondary outcomes were short and long-term course variables. A meta-analysis was performed to calculate risk ratios. Results Twenty-one studies were identified with 5038 patients enrolled. The difference in number of harvested lymph nodes was not statistically significant (MD 0.68, − 0.41–1.76, P = 0.22). The only RCT shows a significant advantage in favour of laparoscopy (MD 3.30, 95% CI − 0.20–6.40, P = 0.04). The analysis of CCTs showed an advantage in favour of the laparoscopic group, but the result was not statically significantly (MD − 0.55, 95% CI − 0.57–1.67, P = 0.33). The overall incidence of local recurrence was not different between the groups, while systemic recurrence at 5 years was lower in laparoscopic group. Laparoscopy showed better short-term outcomes including overall complications, lower estimated blood loss, lower wound infections and shorter hospital stay, despite a longer operative time. The rate of anastomotic and chyle leak was similar in the two groups. Conclusions Despite the several limitations of this study, we found that the median number of lymph node harvested in the laparoscopic group is not different compared to open surgery. Laparoscopy was associated with a lower incidence of systemic recurrence.

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Totally laparoscopic right colectomy with complete mesocolon excision

Cited by 2 publications

References 0 publications

Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer

Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer

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

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