Minimally Invasive Surgery Is Underutilized for Colon Cancer

2011 ◽  
Vol 18 (5) ◽  
pp. 1412-1418 ◽  
Author(s):  
Celia N. Robinson ◽  
G. John Chen ◽  
Courtney J. Balentine ◽  
Shubhada Sansgiry ◽  
Christy L. Marshall ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery

Establishment of a minimally invasive surgery program leads to decreased inpatient cost of care in veterans with colon cancer

2010 ◽  
Vol 200 (5) ◽  
pp. 632-635 ◽  
Author(s):  
Christy L. Marshall ◽  
G. John Chen ◽  
Celia N. Robinson ◽  
Courtney J. Balentine ◽  
Daniel A. Anaya ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Cost Of Care ◽  
Inpatient Cost

scholarly journals Implementing complete mesocolic excision for colon cancer – mission completed?

2018 ◽  
Vol 3 (1) ◽  
pp. 17-29 ◽  
Author(s):  
Roland S. Croner ◽  
Henry Ptok ◽  
Susanne Merkel ◽  
Werner Hohenberger
Keyword(s):  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Complete Mesocolic Excision ◽  
Oncological Outcome ◽  
Standard Of Care ◽  
Published Data ◽  
Mesocolic Excision ◽  
Related Survival

AbstractThe definition of complete mesocolic excision (CME) for colon carcinomas revolutionized the way of colon surgery. This technique conquered the world starting from Erlangen. Nevertheless, currently new developments especially in minimally invasive surgery challenge CME to become settled as a standard of care. To understand the evolution of CME, anatomical details occurring during embryogenesis and their variations have to be considered. This knowledge is indispensable to transfer CME from an open to a minimally invasive setting. Conventional surgery for colon cancer (non-CME) has a morbidity of 12.1–28.5% and a 3.7% mortality risk vs. 12–36.4% morbidity and 2.1–3% mortality for open CME. The morbidity of laparoscopic CME is between 4 and 31% with a mortality of 0.5–0.9%. In robotic assisted surgery, morbidity between 10 and 25% with a mortality of 1% was published. The cancer-related survival after 3 and 5 years for open CME is respectively 91.3–95% and 90% vs. 87% and 74% for non-CME. For laparoscopic CME the 3- and 5-year cancer-related survival is 87.8–97% and 79.5–80.2%. In stage UICC III the 3- and 5-year cancer-related survival is 83.9% and 80.8% in the Erlangen data of open technique vs. 75.4% and 65.5–71.7% for laparoscopic surgery. For stage UICC III the 3- and 5-year local tumor recurrence is 3.8%. The published data and the results from Erlangen demonstrate that CME is safe in experienced hands with no increased morbidity. It offers an obvious survival benefit for the patients which can be achieved solely by surgery. Teaching programs are needed for minimally invasive CME to facilitate this technique in the same quality compared to open surgery. Passing these challenges CME will become the standard of care for patients with colon carcinomas offering all benefits of minimally invasive surgery and oncological outcome.

Minimally Invasive Surgery of Rectal Cancer: Current Evidence and Options

2012 ◽  
pp. 214-218 ◽  
Author(s):  
Atthaphorn Trakarnsanga ◽  
Martin R. Weiser
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Oncologic Outcomes ◽  
Current Status ◽  
Current Evidence ◽  
Short Term ◽  
Invasive Approach

Overview: Minimally invasive surgery (MIS) of colorectal cancer has become more popular in the past two decades. Laparoscopic colectomy has been accepted as an alternative standard approach in colon cancer, with comparable oncologic outcomes and several better short-term outcomes compared to open surgery. Unlike the treatment for colon cancer, however, the minimally invasive approach in rectal cancer has not been established. In this article, we summarize the current status of MIS for rectal cancer and explore the various technical options.

scholarly journals Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study

2021 ◽  
Author(s):  
Marco Milone ◽  
Maurizio Degiuli ◽  
Nunzio Velotti ◽  
Michele Manigrasso ◽  
Sara Vertaldi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Anastomotic Leak ◽  
Invasive Surgery ◽  
Transverse Colon ◽  
Open Approach ◽  
Transverse Colon Cancer ◽  
Robotic Approach ◽  
Solid Diet

AbstractThe role of minimally invasive surgery in the treatment of transverse colon cancer is still controversial. The aim of this study is to investigate the advantages of a totally laparoscopic technique comparing open versus laparoscopic/robotic approach. Three hundred and eighty-eight patients with transverse colon cancer, treated with a segmental colon resection, were retrospectively analyzed. Demographic data, tumor stage, operative time, intraoperative complications, number of harvested lymph nodes and recovery outcomes were recorded. Recurrences and death were also evaluated during the follow-up. No differences were found between conventional and minimally invasive surgery, both for oncological long-term outcomes (recurrence rate p = 0.28; mortality p = 0.62) and postoperative complications (overall rate p = 0.43; anemia p = 0.78; nausea p = 0.68; infections p = 0.91; bleeding p = 0.62; anastomotic leak p = 0.55; ileus p = 0.75). Nevertheless, recovery outcomes showed statistically significant differences in favor of minimally invasive surgery in terms of time to first flatus (p = 0.001), tolerance to solid diet (p = 0.017), time to first mobilization (p = 0.001) and hospital stay (p = 0.004). Compared with laparoscopic approach, robotic surgery showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.005) and tolerance to solid diet (p = 0.001). Finally, anastomosis evaluation confirmed the superiority of intracorporeal approach which showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.003) and tolerance to solid diet (p = 0.001); moreover, we recorded a statistical difference in favor of intracorporeal approach for infection rate (p = 0.04), bleeding (p = 0.001) and anastomotic leak (p = 0.03). Minimally invasive approach is safe and effective as the conventional open surgery, with comparable oncological results but not negligible advantages in terms of recovery outcomes. Moreover, we demonstrated that robotic approach may be considered a valid option and an intracorporeal anastomosis should always be preferred.

scholarly journals Complete mesocolic excision in minimally invasive surgery of colonic cancer: do we need the robot?

2020 ◽  
Author(s):  
Dirk Wilhelm ◽  
Thomas Vogel ◽  
Philipp-Alexander Neumann ◽  
Helmut Friess ◽  
Michael Kranzfelder
Keyword(s):  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Complete Mesocolic Excision ◽  
Current Evidence ◽  
Lymph Node Yield ◽  
Conversion Rates ◽  
Mesocolic Excision

Summary Background Robotic surgery offers favorable prerequisites for complex minimally invasive surgeries which are delivered by higher degrees of freedom, improved instrument stability, and a perfect visualization in 3D which is fully surgeon controlled. In this article we aim to assess its impact on complete mesocolic excision (CME) in colon cancer and to answer the question of whether the current evidence expresses a need for robotic surgery for this indication. Methods Retrospective analysis and review of the current literature on complete mesocolic excision for colon cancer comparing the outcome after open, laparoscopic, and robotic approaches. Results Complete mesocolic excision results in improved disease-free survival and reduced local recurrence, but turns out to be complex and prone to complications. Introduced in open surgery, the transfer to minimally invasive surgery resulted in comparable results, however, with high conversion rates. In comparison, robotic surgery shows a reduced conversion rate and a tendency toward higher lymph node yield. Data, however, are insufficient and no high-quality studies have been published to date. Almost no oncologic follow-up data are available in the literature. Conclusion The current data do not allow for a reliable conclusion on the need of robotic surgery for CME, but show results which hypothesize an equivalence if not superiority to laparoscopy. Due to recently published technical improvements for robotic CME and supplementary features of this method, we suppose that this approach will gain in importance in the future.

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