Comparison of Short-term Results after Laparoscopic Complete Mesocolic Excision and Standard Colectomy for Right-Sided Colon Cancer: Analysis of a Western Center Cohort

被引:11
作者
Conti, Cristian [1 ]
Pedrazzani, Corrado [1 ]
Turri, Giulia [1 ]
Fernandes, Eduardo [2 ]
Lazzarini, Enrico [1 ]
De Luca, Raffaele [3 ]
Valdegamberi, Alessandro [1 ]
Ruzzenente, Andrea [1 ]
Guglielmi, Alfredo [1 ]
机构
[1] Univ Verona, Univ Verona Hosp Trust, Dept Surg Sci Dent Gynecol & Pediat, Div Gen & Hepatobiliary Surg, Verona, Italy
[2] Univ Illinois, Div Minimally Invas Gen & Robot Surg, Chicago, IL USA
[3] IRCCS Ist TUMORI G Paolo II, Dept Surg Oncol, Bari, Italy
关键词
Laparoscopy; Right hemicolectomy; Colonic neoplasms; Complete mesocolic excision; III COLORECTAL-CANCER; CENTRAL VASCULAR LIGATION; LYMPH-NODE DISSECTION; OPEN D3 DISSECTION; ADJUVANT CHEMOTHERAPY; STAGE-II; SURGERY; OUTCOMES; SURVIVAL; RESECTION;
D O I
10.3393/ac.2020.05.18
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Purpose: Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infrequently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME colectomy compared to standard colectomy for right-sided colon cancer in a Western series. Methods: Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were compared to the ones of 55 patients who underwent laparoscopic standard right colectomy. Results: No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P = 0.708), and unplanned readmission in 5.0% vs. 5.5% (P = 1) after CME and standard colectomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), proximal (P = 0.018), and distal margins (P = 0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037). Conclusion: In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to obtain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.
引用
收藏
页码:166 / 173
页数:8
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