How to do a laparoscopic high left colectomy with complete mesocolic excision and central vascular ligation for splenic flexure cancer

2019 ◽  
Vol 89 (5) ◽  
pp. 594-595
Author(s):  
Florin Grama ◽  
Andrei Chitul ◽  
Cosmin Bezede ◽  
Traean Burcoş ◽  
Daniel Cristian
Keyword(s):  
Splenic Flexure ◽  
Complete Mesocolic Excision ◽  
Central Vascular Ligation ◽  
Left Colectomy ◽  
Vascular Ligation ◽  
Mesocolic Excision ◽  
Splenic Flexure Cancer

scholarly journals Laparoscopic complete mesocolic excision with central vascular ligation for splenic flexure colon cancer: short- and long-term outcomes

2021 ◽  
Author(s):  
Kazuki Ueda ◽  
Koji Daito ◽  
Hokuto Ushijima ◽  
Yoshinori Yane ◽  
Yasumasa Yoshioka ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Splenic Flexure ◽  
Complete Mesocolic Excision ◽  
Middle Colic Artery ◽  
Long Term Outcomes ◽  
Central Vascular Ligation ◽  
Vascular Ligation ◽  
Mesocolic Excision ◽  
Short And Long Term

Abstract Background Complete mesocolic excision (CME) with central vascular ligation (CVL) for colon cancer is an essential procedure for improved oncologic outcomes after surgery. Laparoscopic surgery for splenic flexure colon cancer was recently adopted due to a greater understanding of surgical anatomy and improvements in surgical techniques and innovative surgical devices. Methods We retrospectively analyzed the data of patients with splenic flexure colon cancer who underwent laparoscopic CME with CVL at our institution between January 2005 and December 2017. Results Forty-five patients (4.8%) were enrolled in this study. Laparoscopic CME with CVL was successfully performed in all patients. The median operative time was 178 min, and the median estimated blood loss was 20 g. Perioperative complications developed in 6 patients (13.3%). The median postoperative hospital stay was 9 days. According to the pathological report, the median number of harvested lymph nodes was 15, and lymph node metastasis developed in 14 patients (31.1%). No metastasis was observed at the root of the middle colic artery or the inferior mesenteric artery. The median follow-up period was 49 months. The cumulative 5-year overall survival and disease-free survival rates were 85.9% and 84.7%, respectively. The cancer-specific survival rate in stage I-III patients was 92.7%. Recurrence was observed in 5 patients (11.1%), including three patients with peritoneal dissemination and two patients with distant metastasis. Conclusions Laparoscopic CME with CVL for splenic flexure colon cancer appears to be oncologically safe and feasible based on the short- and long-term outcomes in our study. However, it is careful to introduce this procedure to necessitate the anatomical understandings and surgeon’s skill. The appropriate indications must be established with more case registries because our experience is limited.

scholarly journals Complete mesocolic excision and central vascular ligation for right colon cancer: an introduction for abdominal radiologists

2019 ◽  
Vol 44 (11) ◽  
pp. 3518-3526
Author(s):  
David D. B. Bates ◽  
Viktoriya Paroder ◽  
Chandana Lall ◽  
Neeraj Lalwani ◽  
Maria Widmar ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Complete Mesocolic Excision ◽  
Right Colon ◽  
Central Vascular Ligation ◽  
Right Colon Cancer ◽  
Vascular Ligation ◽  
Mesocolic Excision

scholarly journals Robotic Complete Mesocolic Excision with Central Vascular Ligation for Right Colon Cancer: Surgical Technique and Short-term Outcomes

2020 ◽  
Vol 11 (4) ◽  
pp. 674-683
Author(s):  
C. Ramachandra ◽  
Pavan Sugoor ◽  
Uday Karjol ◽  
Ravi Arjunan ◽  
Syed Altaf ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Open Surgery ◽  
Complete Mesocolic Excision ◽  
Right Colon ◽  
Short Term ◽  
Central Vascular Ligation ◽  
Oncological Outcomes ◽  
Right Colon Cancer ◽  
Vascular Ligation ◽  
Mesocolic Excision

Abstract Background Minimally invasive colorectal surgery has demonstrated to have the same oncological results as open surgery, with better clinical outcomes. Robotic assistance is an evolution of minimally invasive technique. Purpose The study aims to present technical details and short-term oncological outcomes of robotic-assisted complete mesocolic excision (CME) with central vascular ligation (CVL) for right colon cancer. Methodology Fifty-two consecutive patients affected by right colon cancer were operated between May 2016 and February 2020 with da Vinci Xi platform. Data regarding surgical and short-term oncological outcomes were systematically collected in a colorectal specific database for statistical analysis. Results Thirty-seven (71.15%) and 15 (28.85%) patients underwent right and extended right hemicoletomy with an extracorporeal anastomosis. Median age was 55 years. Mean operative time was 182 ± 36 min. Mean blood loss was 110 ± 90 ml. Conversion rate was 3.84% (two cases). 78.84% (41 cases) were pT3 and mean number of harvested lymph nodes was 28 ± 4. 1/52 (1.92%) had a documented anastomotic leak requiring exploratory laparotomy and diversion proximal ileostomy. Surgery-related grade IIIa–IIIb Calvien Dindo morbidity were noted in 9.61% and 1.92%, respectively. Conclusion Robotic assistance allows performance of oncological adequate dissection of the right colon with radical lymphadenectomy as in open surgery, confirming the safety and oncological adequacy of this technique, with acceptable results and short-term outcomes.

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