scholarly journals Laparoscopic Wide Mesocolic Excision and Central Vascular Ligation for Carcinoma of the Colon

2016 ◽  
Vol 105 (4) ◽  
pp. 228-234 ◽  
Author(s):  
A. Ehrlich ◽  
M. Kairaluoma ◽  
J. Böhm ◽  
K. Vasala ◽  
H. Kautiainen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Disease Free Survival ◽  
Oncologic Outcome ◽  
Complete Mesocolic Excision ◽  
Central Vascular Ligation ◽  
Free Survival ◽  
Carcinoma Of The Colon ◽  
Vascular Ligation ◽  
Mesocolic Excision ◽  
Disease Free

Background and Aims: The principle of complete mesocolic excision for colon cancer has been introduced to improve oncologic outcome. However, this approach is scantily discussed for laparoscopic surgery and there is a lack of randomized trials. This study examined oncologic and clinical outcome after laparoscopic wide mesocolic excision and central vascular ligation for colon cancer. Material and Methods: This is a review of prospectively gathered data from a single-institution colorectal cancer database. This study was conducted in the Central Hospital of Central Finland. From January 2003 to December 2011, 222 patients underwent laparoscopic colonic resections with wide mesocolic excision and central vascular ligation in the multimodal setting. The main measures of outcome were cancer recurrence and survival, with early recovery, 30d-mortality and morbidity, reoperation, readmission, and late complications as secondary outcomes. Results: The median follow-up was 5.5 (interquartile range (IQR) = 3.7–8.0) years. The 5-year overall survival for all 222 patients was 80.2% and disease-specific survival was 87.5%, and for those 210 R0-patients with stage I–III disease, 83.9% and 91.3%, respectively. The 5-year disease-free survival was 85.8%: stage I was 94.7%, stage II was 90.8%, and stage III was 75.6% ( p = 0.004). Increasing lymph node ratio significantly decreased the 5-year disease-free survival. Conversion rate to open surgery was 12.2%. Thirty-day mortality was 1.3% and morbidity, 19.7%. Median postoperative hospital stay was 5 (IQR = 3–7) days. Conclusion: Laparoscopic wide mesocolic excision and central vascular ligation for colon cancer resulted in good long-term oncologic outcome. Randomized trials are needed to show that laparoscopic complete mesocolic excision technique would become the standard of care for the carcinoma of the colon.

scholarly journals Long-term outcomes after complete mesocolic excision for colon cancer at a tertiary care center in Saudi Arabia

2020 ◽  
Vol 40 (3) ◽  
pp. 207-211
Author(s):  
Reem A. Alharbi ◽  
Riyadh Hakami ◽  
Khayal A. Alkhayal ◽  
Omar A. Al-Obeed ◽  
Thamer A. Bin Traiki ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Care Center ◽  
Tertiary Care ◽  
Disease Free Survival ◽  
Complete Mesocolic Excision ◽  
Recurrence Rates ◽  
Free Survival ◽  
Mesocolic Excision ◽  
Disease Free

ABSTRACT BACKGROUND: Data on long-term survival and recurrence of cancer after complete mesocolic excision (CME) for colon cancer has not been reported from our center and related to international data. OBJECTIVE: Describe overall and disease-free survival, survival by surgery site and stage, and recurrence rates after curative surgery. DESIGN: Retrospective chart review. SETTINGS: Academic tertiary care center. PATIENTS AND METHODS: The study included all patients who underwent either laparoscopic or open surgery for colon cancer with curative intent between 2001 and 2011. The colorectal database was reviewed for the following: demographic data, comorbidities, radiologic investigations, clinical stage, type of operation, complications, pathologic assessment, adjuvant treatment, recurrence and survival. Survival and recurrence rates were calculated, and survival curves were generated. MAIN OUTCOME MEASURES: 5-year overall survival, secondary endpoints were 5-year disease-free survival, survival by surgery site and stage, and recurrence rates. SAMPLE SIZE: 220. RESULTS: The mean (SD) age at diagnosis was 57 (13) years (CI 95%: 55-59 years). There were 112 males. Mean (SD) body mass index was 27.6 (5.7) kg/m 2 (CI 95%: 27-28). Pathological assessment revealed R0 (microscopically margin-negative) resection in 207 (94%). The overall 5-year survival and disease-free survival was 77.9% and 70%, respectively. The 5-year disease-free survival was 69% for the sigmoid/left colon and 69% for the right colon (difference statistically nonsignificant). Stages at the time of resection were stage 0 for 2 (0.01%) patients, stage I for 18 (8%), stage II for 92 (42%), stage III for 100 (46%), and stage IV for 6 (3%). The 5-year overall survival by stages I, II, III and IV was 94%, 80%, 75% and 50%, respectively (difference statistically non-significant). The overall 5-year recurrence rate was 23.4%. CONCLUSION: The outcomes of surgical treatment for colon cancer at our institution are equivalent to international sites. No difference was noted between left and right colon in terms of survival after CME. LIMITATIONS: Single center, retrospective, small sample size. CONFLICT OF INTEREST: None.

Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study

2015 ◽  
Vol 16 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Claus Anders Bertelsen ◽  
Anders Ulrich Neuenschwander ◽  
Jens Erik Jansen ◽  
Michael Wilhelmsen ◽  
Anders Kirkegaard-Klitbo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Disease Free Survival ◽  
Complete Mesocolic Excision ◽  
Population Based ◽  
Cancer Surgery ◽  
Population Based Study ◽  
Free Survival ◽  
Mesocolic Excision ◽  
Colon Cancer Surgery ◽  
Disease Free

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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