Multicenter Controlled Study of Intracorporeal Mechanical Side-to-Side Isoperistaltic Anastomosis versus Extracorporeal Anastomosis in Laparoscopic Right Hemicolectomy: HEMI-D-TREND-Study

Colorectal cancer is the second most frequent cancer in the Western world. A third of colorectal tumors are located in the right colon, and right hemicolectomy is the treatment in nondisseminated right colon cancer. The most serious complication of this procedure is anastomotic leak, which occurs in 8.4% of cases. At present, there is no standardized technique for laparoscopic ileo-colic anastomosis. In previous observational studies, intracorporeal side-to-side ileo-colic laparoscopic anastomosis has shown better results than extracorporeal anastomosis in terms of morbidity and mortality. It is known that randomized studies provide higher levels of evidence, but multicenter randomized controlled studies may imply a learning curve bias due to the differences in technical experience acquired at each hospital. As a result, we propose to carry out a prospective, controlled, nonrandomized TREND-study design (Transparent Reporting of Evaluations with Non-randomized Designs-TREND) in a large sample of 416 patients (208 per group) in order to assess the use of intracorporeal side-to-side ileo-colic laparoscopic anastomosis as the gold standard in right hemicolectomy.

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Systematic review of comparing single-incision versus conventional laparoscopic right hemicolectomy for right colon cancer

World Journal of Surgical Oncology ◽

10.1186/s12957-019-1721-6 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 2

Author(s):

Xin Liu ◽

Wei-hong Yang ◽

Zhou-guang Jiao ◽

Ji-fu Zhang ◽

Rui Zhang

Keyword(s):

Colon Cancer ◽

Meta Analysis ◽

Right Hemicolectomy ◽

Right Colon ◽

Chi Square ◽

Right Colon Cancer ◽

Laparoscopic Right Hemicolectomy ◽

Operation Duration ◽

The Right

Abstract Background Single-incision laparoscopic right hemicolectomy (SILS) has long used in surgery for a long time. However, there is barely a systemic review related to the comparison between the SILS and the conventional laparoscopic right hemicolectomy (CLS) for the right colon cancer in the long term follow-up. Herein, we used the most recent articles to compare these two techniques by meta-analysis. Methods We searched PubMed, Web of Science, Cochrane Library and Wanfang databases to compare SILS with CLS for right colon cancer up to May 2019. The operative, postoperative, pathological and mid-term follow-up outcomes of nine studies were extracted and compared. Results A total of 1356 patients participated in 9 studies, while 653 patients were assigned to the SILS group and 703 patients were assigned to the CLS group. The patients’ baselines in the SILS group were consistent with those in the CLS group. Compared to the CLS group, the SILS group had a shorter operation duration (SMD − 23.49, 95%CI − 36.71 to − 10.27, P < 0.001, chi-square = 24.11), shorter hospital stay (SMD − 0.76, 95% `CI − 1.07 to − 0.45, P < 0.001, chi-square = 9.85), less blood loss (SMD − 8.46, 95% CI − 14.59 to − 2.34; P < 0.05; chi-square = 2.26), smaller incision length (SMD − 1.60, 95% CI − 2.66 to − 0.55, P < 0.001; chi-square = 280.44), more lymph node harvested (SMD − 0.98, 95% CI − 1.79 to − 0.16, P < 0.05; chi-square = 4.61), and a longer proximal surgical edge (SMD − 0.51, 95% CI − 0.93 to − 0.09, P < 0.05; chi-square = 2.42). No significant difference was found in other indexes. After we removed a single large study, we performed another meta-analysis again. The operation duration in the SILS group was still better than that in the CLS group. Conclusion SILS could be a faster and more reliable approach than CLS for the right colon cancer and could accelerate patient recovery, especially for patients with a low BMI.

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“Caudal-to-cranial” plus “artery first” technique with beyond D3 lymph node dissection on the right midline of the superior mesenteric artery for the treatment of right colon cancer: is it more in line with the principle of oncology?

Surgical Endoscopy ◽

10.1007/s00464-019-07171-5 ◽

2019 ◽

Vol 34 (9) ◽

pp. 4089-4100 ◽

Cited By ~ 2

Author(s):

Xiaojiang Yi ◽

Hongming Li ◽

Xinquan Lu ◽

Jin Wan ◽

Dechang Diao

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Node Dissection ◽

Right Colon ◽

Right Colon Cancer ◽

Artery First ◽

The Right ◽

D3 Lymph Node Dissection

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Synchronous robotic right hemicolectomy and subtotal gastrectomy

Updates in Surgery ◽

10.1007/s13304-020-00866-8 ◽

2020 ◽

Vol 72 (4) ◽

pp. 1273-1277

Author(s):

Fabio Carbone ◽

Ugo Pace ◽

Vittorio Albino ◽

Maddalena Leongito ◽

Paolo Delrio

Keyword(s):

Cancer Diagnosis ◽

Minimal Invasive Surgery ◽

Subtotal Gastrectomy ◽

Right Hemicolectomy ◽

Minimal Invasive ◽

Right Colon ◽

Minimal Invasiveness ◽

Synchronous Colorectal Cancer ◽

The Right ◽

Robotic Resection

AbstractAbout 4% of patients with stomach cancer diagnosis have synchronous colorectal cancer and some of these patients may require a synchronous surgical resection. So far, only few minimally invasive series of synchronous resections have been described. We investigated the feasibility and safety of the synchronous robotic resection of the right colon and stomach malignancies, trying to identify a standardised and reproducible technique. It is essential to carefully plan the operation and the trocars positioning to minimise the number of robotic dockings and be able to operate comfortably. Herein, we describe our approach, which is safe and effective in terms of minimal invasiveness and oncological radicality. Robotic surgery could be used with even more advantage in complex multi-organ resections, providing the surgeon with a better vision, a more accurate dissection and longer instruments, to offer the patient all the benefits of a minimal invasive surgery.

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Vascular Structures of the Right Colon: Incidence and Variations with Their Clinical Implications

Scandinavian Journal of Surgery ◽

10.1177/1457496916650999 ◽

2016 ◽

Vol 106 (2) ◽

pp. 107-115 ◽

Cited By ~ 20

Author(s):

J. Alsabilah ◽

W. R. Kim ◽

N. K. Kim

Keyword(s):

Colon Cancer ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Vascular Anatomy ◽

Colic Artery ◽

Right Colon ◽

Right Colon Cancer ◽

Vascular Structures ◽

Gastrocolic Trunk ◽

The Right

Background and Aims: There is a demand for a better understanding of the vascular structures around the right colonic area. Although right hemicolectomy with the recent concept of meticulous lymph node dissection is a standardized procedure for malignant diseases among most surgeons, variations in the actual anatomical vascular are not well understood. The aim of the present review was to present a detailed overview of the vascular variation pertinent to the surgery for right colon cancer. Materials and Methods: Medical literature was searched for the articles highlighting the vascular variation relevant to the right colon cancer surgery. Results: Recently, there have been many detailed studies on applied surgical vascular anatomy based on cadaveric dissections, as well as radiological and intraoperative examinations to overcome misconceptions concerning the arterial supply and venous drainage to the right colon. Ileocolic artery and middle colic artery are consistently present in all patients arising from the superior mesenteric artery. Even though the ileocolic artery passes posterior to the superior mesenteric vein in most of the cases, in some cases courses anterior to the superior mesenteric artery. The right colic artery is inconsistently present ranging from 63% to 10% across different studies. Ileocolic vein and middle colic vein is always present, while the right colic vein is absent in 50% of patients. The gastrocolic trunk of Henle is present in 46%–100% patients across many studies with variation in the tributaries ranging from bipodal to tetrapodal. Commonly, it is found that the right colonic veins, including the right colic vein, middle colic vein, and superior right colic vein, share the confluence forming the gastrocolic trunk of Henle in a highly variable frequency and different forms. Conclusion: Understanding the incidence and variations of the vascular anatomy of right side colon is of crucial importance. Failure to recognize the variation during surgery can result in troublesome bleeding especially during minimal invasive surgery.

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Is Laparoscopic CME Right Hemicolectomy an Optimal Indication for NET of the Right Colon and Terminal Ileum?

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-020-04682-8 ◽

2020 ◽

Author(s):

C. Pedrazzani ◽

C. Conti ◽

A. Valdegamberi ◽

M. V. Davì ◽

S. Cingarlini ◽

...

Keyword(s):

Terminal Ileum ◽

Right Hemicolectomy ◽

Right Colon ◽

The Right

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The Impact of Split-dosed Bowel Preparation on Polyp Detection Rate in the Right Colon: Results of a Randomized Controlled Study

The American Journal of Gastroenterology ◽

10.14309/00000434-201110002-01503 ◽

2011 ◽

Vol 106 ◽

pp. S574-S575

Author(s):

Jason Samarasena ◽

Venkataraman Muthusamy ◽

Mazen M. Jamal

Keyword(s):

Bowel Preparation ◽

Detection Rate ◽

Randomized Controlled Study ◽

Controlled Study ◽

Polyp Detection ◽

Right Colon ◽

Randomized Controlled ◽

Polyp Detection Rate ◽

The Right ◽

The Impact

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En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases

Einstein (São Paulo) ◽

10.1590/s1679-45082010rc786 ◽

2010 ◽

Vol 8 (1) ◽

pp. 97-101 ◽

Cited By ~ 2

Author(s):

Sergio Renato Pais Costa ◽

Sergio Henrique Couto Horta ◽

Alexandre Cruz Henriques ◽

Jaques Waisberg ◽

Manlio Basílio Speranzini

Keyword(s):

Colon Cancer ◽

Locally Advanced ◽

Pancreatic Head ◽

Multivisceral Resection ◽

Right Hemicolectomy ◽

Right Colon ◽

En Bloc ◽

Term Survival ◽

Proximal Duodenum ◽

Right Colon Cancer

ABSTRACT Although colorectal tumors are fairly common surgical conditions, 5 to 12% of these tumors are locally advanced (T4 tumors) upon diagnosis. In this particular situation, the efficacy of en bloc multivisceral resection has been proven. When right-colon cancer invades the proximal duodenum or even the pancreatic head, a challenging dilemma arises due to complexity of the curative surgical procedure. Therefore, en bloc pancreaticoduodenectomy with right hemicolectomy should be performed to obtain free margins. The present study reports three cases of locally advanced right-colon cancer invading the proximal duodenum. All of these cases underwent successful en bloc pancreaticoduodenectomy plus right hemicolectomy, with no death occurrence. Long-term survival was observed in two cases (30 and 50 months). In the third case, the patient did not present any recurrence twelve months after surgical treatment. Multivisceral resection with en bloc pancreaticoduodenectomy should be considered for patients who present acceptable risk for major surgery and no distant dissemination. This approach seems justified since the length of postoperative survival is longer in radically ressected groups (R0) than in palliativelly resected groups (R1-2).

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Outcomes after combined right hemicolectomy and pancreaticoduodenectomy for locally advanced right-sided colon cancer: a case series

10.22514/sv.2020.16.0095 ◽

2020 ◽

Keyword(s):

Colon Cancer ◽

Locally Advanced ◽

Case Series ◽

Disease Free Survival ◽

Right Hemicolectomy ◽

R0 Resection ◽

Right Colon ◽

En Bloc ◽

Mortality And Morbidity ◽

Right Colon Cancer

Background: Although right colon cancers mostly grow intraluminally, they may rarely invade neighboring organs without distant organ metastasis. En bloc resection is required for R0 resection in pancreas and duodenum-invasive right colon tumors. Despite the high mortality and morbidity rates, the en bloc right hemicolectomy and pancreaticoduodenectomy (RHPD) procedure can be safely performed in centers experienced in colorectal and hepatobiliary surgery. Objective: In this study, we aimed to share the results of our patients who underwent en bloc pancreaticoduodenectomy in addition to right hemicolectomy for cases with locally advanced right colon cancer. Materials and Methods: Patients who were operated on the right colon cancer between January 2010 and March 2018 were retrospectively screened. Patients who underwent RHPD due to locally advanced colon cancer invading the duodenum and pancreas were included in this study. RHPD was performed in cases where radical resection was deemed appropriate, and R0 resection could be performed. Demographic information, intraoperative and postoperative findings, and long-term follow-up data of the patients were recorded. Results: Six cases underwent RHPD. All of the cases were male, and the mean age was 67 ± 6. Proximal PD was performed in five cases, and total PD was performed in one case. SMV reconstruction was performed in one case with an SMV invasion. One case died due to pneumonia and anastomotic leak in the postoperative period. The other five patients had a mean disease-free survival of 29.2 ± 14.7 months. The 1 and 2-year survival rate was 66.6% and 66.6%, respectively. Conclusion: RHPD is a surgical operation that can be performed safely in experienced centers with acceptable mortality and morbidity rates in cases suitable for R0 resection.

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