BackgroundColectomies performed according to complete mesocolic excision (CME) principles have demonstrated an improvement in the quality of surgical specimen and a potential improvement of long-term results. Laparoscopic CME right hemicolectomy is considered a demanding procedure and adopted in few centers from the West. The main purpose of this paper is to present a video showing our technique for laparoscopic CME right hemicolectomy and to analyze our short-term results to prove its safety.MethodsData from 38 patients operated on at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust, between September 2014 and February 2017, were included in the study.ResultsIn the present series, 37% of patients were 75 years old, 32% of patients were ASA class 3, 46% of patients had 2 comorbidities, 30% of patients had BMI >28 and 17% of patients had 2 previous abdominal surgeries. Despite these unfavorable clinic characteristics, no mortality was observed, Clavien-Dindo 3 complications occurred in 13.1% and redo surgery in 5.3%. Good quality specimens were obtained with a mean (SD) length of 34.57.5 cm, a proximal margin of 16.8 +/- 9.2 cm and a distal margin of 14.3 +/- 6.4 cm. The mean (SD) number of harvested lymph nodes was 24.3 (8.3).ConclusionsWhen implemented in a Western center, laparoscopic CME right hemicolectomy is feasible and safe and allows obtaining good quality specimens.

Laparoscopic Complete Mesocolic Excision for Right-Sided Colon Cancer: Analysis of Feasibility and Safety from a Single Western Center

Pedrazzani, Corrado
;
Lazzarini, Enrico;Turri, Giulia;Conti, Cristian;Tombolan, Valeria;Nifosì, Filippo;Guglielmi, Alfredo
2019-01-01

Abstract

BackgroundColectomies performed according to complete mesocolic excision (CME) principles have demonstrated an improvement in the quality of surgical specimen and a potential improvement of long-term results. Laparoscopic CME right hemicolectomy is considered a demanding procedure and adopted in few centers from the West. The main purpose of this paper is to present a video showing our technique for laparoscopic CME right hemicolectomy and to analyze our short-term results to prove its safety.MethodsData from 38 patients operated on at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust, between September 2014 and February 2017, were included in the study.ResultsIn the present series, 37% of patients were 75 years old, 32% of patients were ASA class 3, 46% of patients had 2 comorbidities, 30% of patients had BMI >28 and 17% of patients had 2 previous abdominal surgeries. Despite these unfavorable clinic characteristics, no mortality was observed, Clavien-Dindo 3 complications occurred in 13.1% and redo surgery in 5.3%. Good quality specimens were obtained with a mean (SD) length of 34.57.5 cm, a proximal margin of 16.8 +/- 9.2 cm and a distal margin of 14.3 +/- 6.4 cm. The mean (SD) number of harvested lymph nodes was 24.3 (8.3).ConclusionsWhen implemented in a Western center, laparoscopic CME right hemicolectomy is feasible and safe and allows obtaining good quality specimens.
2019
Colon cancer
Complete mesocolic excision
Laparoscopy
Minimally invasive surgery
Right hemicolectomy
Aged
Colectomy
Colon, Ascending
Colon, Transverse
Colonic Neoplasms
Feasibility Studies
Female
Humans
Laparoscopy
Lymph Node Excision
Lymph Nodes
Male
Mesocolon
Middle Aged
Postoperative Complications
Reoperation
Retrospective Studies
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1029668
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