Preview

Surgery and Oncology

Advanced search

Short-term and long-term outcomes of laparoscopic right hemicolectomy with d3 lymph node dissection: experience of one clinic

https://doi.org/10.17650/2220-3478-2018-8-2-11-17

Abstract

Objective: to assess short-term and long-term outcomes of right hemicolectomy with extensive lymph node dissection using the experience of one clinic.

Materials and methods. This retrospective study analyzed data from a prospectively collected database containing information on all patients with right-sided colon cancer that underwent laparoscopic right hemicolectomy with D3 lymph node dissection between 2013 and 2018. We estimated intraoperative blood loss, surgery duration (taken from anesthetic records), frequency of postoperative complications, length of in-hospital stay, duration of lymphorrhea, time to gastrointestinal recovery, integrity of the mesocolon, number and location of removed lymph nodes.

ResultsA total of 50 underwent laparoscopic right hemicolectomy with D3 lymph node dissection. No cases of surgical conversion were registered. Median surgery duration was 185 min; median blood loss was 30 mL. No postoperative mortality was observed in the study cohort. Twelve (24 %) patients had postoperative complications; 2 (4 %) patients underwent repeated surgery. Median number of lymph nodes examined was 26; high-quality specimens (G ) were obtained in 48 (96 %) patients. At a median follow-up of 19.5 months, 2 (4 %) patients had disease progression (developed liver metastases).

Conclusion. Our results confirm safety of laparoscopic approach for right colon resection with D3 lymph node dissection

About the Authors

O. A. Rakhimov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



S. S. Gordeev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



V. A. Aliev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



Z. Z. Mamedli
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



D. V. Kuzmichev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



Yu. A. Barsukov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



A. O. Rasulov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation

Surgical Department No. 3 (Department of Proctology)

23 Kashirskoe Shosse, Moscow 115478



References

1. Hohenberger W., Weber K., Matzel K. et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation – technical notes and outcome. Colorectal Dis 2009;11(4):354–64; discussion 364–5. PMID: 19016817. DOI: 10.1111/j.1463-1318.2008.01735.x.

2. Bertelsen C.A., Neuenschwander A.U., Jansen J.E. et al. Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study. Lancet Oncol 2015;16(2):161–8. PMID: 25555421. DOI: 10.1016/S1470-2045(14)71168-4.

3. Agalianos C., Gouvas N., Dervenis C. et al. Is complete mesocolic excision oncologically superior to conventional surgery for colon cancer? A retrospective comparative study. Ann Gastroenterol 2017;30(6):688–96. PMID: 29118565. DOI: 10.20524/aog.2017.0197.

4. Watanabe T., Itabashi M., Shimada Y. et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol 2012;17(1):1–29. DOI: 10.1007/s10147-011-0315-2.

5. Lassen K., Soop M., Nygren J. et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg 2009;144(10):961–9. PMID: 19841366. DOI: 10.1001/archsurg. 2009.170.

6. Clavien P.A., Barkun J., de Oliveira M.L. et al. The Clavien – Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250(2):187–96. PMID: 19638912. DOI: 10.1097/SLA.0b013e3181b13ca2.

7. West N.P., Hohenberger W., Weber K. et al. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol 2010;28(2):272–8. PMID: 19949013. DOI: 10.1200/JCO.2009.24.1448.

8. Zhao L.Y., Liu H., Wang Y.N. et al. Techniques and feasibility of laparoscopic extended right hemicolectomy with D3 lymphadenectomy. World J Gastroenterol 2014;20(30):10531–6. PMID: 25132772. DOI: 10.3748/wjg.v20.i30.10531.

9. Lacy A.M., García-Valdecasas J.C., Delgado S. et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002;359(9325):2224–9. PMID: 12103285. DOI: 10.1016/S0140-6736(02)09290-5.

10. Lacy A.M., Delgado S., Castells A. et al. The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg 2008;248(1):1–7. PMID: 18580199. DOI: 10.1097/SLA.0b013e31816a9d65.

11. Jayne D.G., Thorpe H.C., Copeland J. et al. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 2010;97(11):1638–45. PMID: 20629110. DOI: 10.1002/bjs.7160.

12. Green B.L., Marshall H.C., Collinson F. et al. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 2013;100(1):75–82. PMID: 23132548. DOI: 10.1002/bjs.8945.

13. Jayne D.G., Guillou P.J., Thorpe H. et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 2007;25(21):3061–8. PMID: 17634484. DOI: 10.1200/JCO.2006.09.7758.

14. Guillou P.J., Quirke P., Thorpe H. et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 2005;365(9472): 1718–26. PMID: 15894098. DOI: 10.1016/S0140-6736(05)66545-2.

15. Veldkamp R., Kuhry E., Hop W.C. et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 2005;6(7):477–84. PMID: 15992696. DOI: 10.1016/S1470-2045(05)70221-7.

16. Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M., Veldkamp R. et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 2009;10(1):44–52. PMID: 19071061. DOI: 10.1016/S1470-2045(08)70310-3.

17. Clinical Outcomes of Surgical Therapy Study Group, Nelson H., Sargent D.J. et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350(20): 2050–9. PMID: 15141043. DOI: 10.1056/NEJMoa032651.

18. Fleshman J., Sargent D.J., Green E. et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 2007;246(4):655–62; discussion 662–4. PMID: 17893502. DOI: 10.1097/SLA.0b013e318155a762.

19. Athanasiou C.D., Markides G.A., Kotb A. et al. Open compared with laparoscopic complete mesocolic excision with central lymphadenectomy for colon cancer: a systematic review and meta-analysis. Colorectal Dis 2016;18(7):O224–35. PMID: 27187520. DOI: 10.1111/codi. 13385.

20. Yamamoto S., Inomata M., Katayama H. et al. Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404. Ann Surg 2014;260(1):23–30. PMID: 24509190. DOI: 10.1097/SLA.0000000000000499.

21. Shin J.W., Amar A.H., Kim S.H. et al. Complete mesocolic excision with D3 lymph node dissection in laparoscopic colectomy for stages II and III colon cancer: long-term oncologic outcomes in 168 patients. Tech Coloproctol 2014;18(9):795–803. PMID: 24633427. DOI: 10.1007/s10151-014-1134-z.


Review

Views: 986


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2949-5857 (Online)