Right colon cancer surgery: current state

Background Anastomotic leak (AL) is one of the most important postoperative complications after hemicolectomy with stapled anastomosis. This study aimed to evaluate the association of preoperative vitamin D3 with early anastomotic leakage after right colon cancer surgery with stapled anastomosis. Method In this prospective cohort study, 535 patients who underwent right colon cancer surgery (right hemicolectomy) with stapled anastomosis were enrolled. A subset of 315 patients was included in the study after meeting the inclusion criteria. Preoperative vitamin D level was measured and analyzed for association with early AL using univariable and multivariable logistic regression analyses. Result This study included 315 cases; among them, 18 (5.71%) patients developed early AL. Vitamin D3 was significantly higher among patients without early AL ( P < .001). Low vitamin D3 status was reported among 111 patients (35.2%) and 204 (64.8%) of patients did not have low vitamin D3 status (sufficient level = 30-100 ng/mL). Sufficient vitamin D3 levels before right colon cancer surgery with stapled anastomosis was associated inversely with early AL (crude OR = .89, 95% CI = .85-.94, P < .001 and adjusted OR = .89, 95% CI = .82-.98, P = .02). Conclusion The vitamin D3 level has a protective association with early AL. As a result, low vitamin D3 status may be a risk factor for early AL development, suggesting that it can be one of the predictors of early AL occurrence.

Download Full-text

Physical Activity and Its Impact on Colon Cancer Surgery

Case Medical Research ◽

10.31525/ct1-nct03947840 ◽

2019 ◽

Author(s):

Keyword(s):

Physical Activity ◽

Colon Cancer ◽

Cancer Surgery ◽

Colon Cancer Surgery

Download Full-text

Modified Complete Mesocolic Excision (mCME) for Right Colon Cancer

Case Medical Research ◽

10.31525/ct1-nct03992599 ◽

2019 ◽

Author(s):

Keyword(s):

Colon Cancer ◽

Complete Mesocolic Excision ◽

Right Colon ◽

Right Colon Cancer ◽

Mesocolic Excision

Download Full-text

Factors associated with diet failure after colon cancer surgery

Surgical Endoscopy ◽

10.1007/s00464-021-08575-y ◽

2021 ◽

Author(s):

Kiho You ◽

Dae Kyung Sohn ◽

Sung Sil Park ◽

Sung Chan Park ◽

Jae Hwan Oh ◽

...

Keyword(s):

Colon Cancer ◽

Cancer Surgery ◽

Factors Associated ◽

Colon Cancer Surgery

Download Full-text

A case of portal venous gas after obstructive transverse colon cancer surgery

Surgical Case Reports ◽

10.1186/s40792-019-0729-z ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Yuichiro Furutani ◽

Chikashi Hiranuma ◽

Masakazu Hattori ◽

Kenji Doden ◽

Yasuo Hashizume

Keyword(s):

Colon Cancer ◽

Conservative Treatment ◽

Anastomotic Leakage ◽

Transverse Colon ◽

Cancer Surgery ◽

Transverse Colon Cancer ◽

Bowel Necrosis ◽

Entire Area ◽

Portal Venous Gas ◽

Colon Cancer Surgery

Abstract Background Portal venous gas has traditionally been considered an inevitable harbinger of death due to its association with bowel necrosis. Recently, an increasing number of cases of portal venous gas have been reported in patients with various clinical conditions and without bowel necrosis. We herein report the case of a patient in whom portal venous gas developed after transverse colon cancer surgery. Case presentation A 69-year-old man who had transverse colon cancer underwent insertion of a transanal ileus tube for decompression. Transverse colon resection was performed on the 11th day after the insertion of the transanal ileus tube. The patient had a high fever on the 6th day after the operation. Computed tomography showed portal venous gas over the entire area of the liver and pneumatosis intestinalis in the wall of the ascending colon. There were no signs of anastomotic leakage or bowel necrosis, so we decided to use conservative therapy with fasting and antibiotics. The portal venous gas disappeared on the 19th day after the operation. The patient was discharged in good condition on the 29th day after the operation. Conclusions Conservative treatment for portal venous gas is reasonable for patients without signs of anastomotic leakage or bowel necrosis. However, it is important to carefully observe patients with portal venous gas during conservative treatment because portal venous gas may be life-threatening.

Download Full-text

A learning curve in using organ retractor for single-incision laparoscopic right colectomy

Scientific Reports ◽

10.1038/s41598-021-86168-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Toshio Shiraishi ◽

Tetsuro Tominaga ◽

Takashi Nonaka ◽

Kiyoaki Hamada ◽

Masato Araki ◽

...

Keyword(s):

Colon Cancer ◽

Laparoscopic Surgery ◽

Blood Loss ◽

Learning Curve ◽

Single Incision ◽

Operation Time ◽

Perioperative Outcomes ◽

Single Incision Laparoscopic Surgery ◽

Right Colon ◽

Right Colon Cancer

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.

Download Full-text

Gastrocolic ligament lymph-node dissection may increase the incidence of delayed gastric emptying after colon cancer surgery with D3 lymphadenectomy

Surgery Today ◽

10.1007/s00595-020-02200-6 ◽

2021 ◽

Author(s):

Yu Deng ◽

Shenghui Huang ◽

Mingjin Huang ◽

Xiaojie Wang ◽

Ying Huang ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Gastric Emptying ◽

Lymph Node Dissection ◽

Delayed Gastric Emptying ◽

Cancer Surgery ◽

Node Dissection ◽

D3 Lymphadenectomy ◽

Colon Cancer Surgery

Download Full-text

Comparison of postoperative recovery of patients who underwent laparoscopic-assisted radical resection of right colon cancer with modified triangular anastomosis or tubular anastomosis: a retrospective cohort study

BMC Surgery ◽

10.1186/s12893-021-01086-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tianfang Xia ◽

Zhenguo Pan ◽

Jie Zhang ◽

Guo Xu

Keyword(s):

Colon Cancer ◽

Digestive Tract ◽

Transverse Colon ◽

Retrospective Cohort ◽

Radical Resection ◽

Anastomosis Group ◽

Group Differences ◽

Right Colon ◽

Right Colon Cancer ◽

Laparoscopic Assisted

Abstract Background We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer. Methods This was a retrospective cohort analysis of 92 cases of laparoscopic-assisted resection of right colon cancer, treated from June 2017 to June 2018, at the Huai’an No. 1 People’s Hospital in China. Patients were divided into a modified triangular anastomosis group (n = 33) and a tubular anastomosis group (n = 59). In the modified triangular anastomosis group, digestive tract reconstruction was conducted using side-to-side anastomosis of the ileo-transverse colon with a 60-mm linear stapler. The common entry hole was closed with a running suture. The tubular anastomosis group underwent end-to-side anastomosis of the ileo-transverse colon with a tubular stapler anchor placed at the end of the ileum. Results At baseline and perioperatively, there were no significant between-group differences in age, sex, body mass index, tumor location, pathological stage, or tumour size (P > 0.05). There were also no significant between-group differences in operation time, estimated blood loss, the number of harvested lymph nodes, the first postoperative flatulence time, hospitalisation time, or postoperative complications (P > 0.05); however, the total cost of hospitalization for the triangular anastomosis group was significantly lower than the tubular anastomosis group (P < 0.05). Conclusion Modified triangular anastomosis is a safe and feasible procedure for laparoscopic-assisted radical resection of right colon cancer. These results affirm the safety and effectiveness of total laparoscopic radical resection of right colon cancer. Given the equivalent outcomes between the two procedures, the modified triangular procedure may be more a more cost-effective option for clinical application.

Download Full-text