1. Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer
- Author
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Giuseppe Di Buono, Elisa Maienza, Vincenzo Sorce, Massimo Galia, Gianfranco Cocorullo, Giorgio Romano, Giulia Bonventre, Salvatore Buscemi, Giuseppe Amato, Antonino Agrusa, Leonardo Gulotta, Di Buono, Giuseppe, Buscemi, Salvatore, Cocorullo, Gianfranco, Sorce, Vincenzo, Amato, Giuseppe, Bonventre, Giulia, Maienza, Elisa, Galia, Massimo, Gulotta, Leonardo, Romano, Giorgio, and Agrusa, Antonino
- Subjects
medicine.medical_specialty ,Colorectal cancer ,MEDLINE ,Anastomosis ,law.invention ,Clinical study ,03 medical and health sciences ,Text mining ,0302 clinical medicine ,Randomized controlled trial ,law ,Humans ,Medicine ,laparoscopic colonic resection ,business.industry ,General surgery ,medicine.disease ,laparoscopic surgery ,Term (time) ,Surgery ,Settore MED/18 - Chirurgia Generale ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,right colon cancer ,Feasibility Studies ,Operative time ,Laparoscopy ,030211 gastroenterology & hepatology ,complete mesocolic excision ,Lymph ,Specimen length ,business ,Ligation ,Mesocolon - Abstract
OBJECTIVE The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group). SUMMARY BACKGROUND DATA Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use. METHODS In this randomized controlled trial, several primary endpoints (operative time, intraoperative blood loss, other complications, conversion rate, and anastomotic leak) and secondary endpoints (overall postoperative complications) were evaluated. In addition, we evaluated histopathologic data, including specimen length and the number of lymph nodes harvested, as objective signs of the quality of CME, related to oncological outcomes. RESULTS The CME group had a significantly longer mean operative time than the NCME group (216.3 minutes vs 191.5 minutes, P = 0.005). However, the CME group had a higher number of lymph nodes (23.8 vs 16.6; P < 0.001) and larger surgical specimens (34.3 cm vs 29.3 cm; P = 0.002). No differences were reported with respect to intraoperative blood loss, conversion rate, leakage, or other postoperative complications. CONCLUSIONS In this study laparoscopic CME were a safe and feasible technique with improvement in lymph nodes harvesting and length of surgical specimens with no increase of surgical intraoperative and postoperative complications.
- Published
- 2020
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