scholarly journals Manual intracorporeal end-to-end invagination ileotransverse anastomosis, own experience

2021 ◽  
Vol 20 (1) ◽  
pp. 23-31
Author(s):  
M. P. Salamachin ◽  
T. S. Dergacheva ◽  
O. V. Leonov ◽  
D. V. Sidorov ◽  
A. O. Soloviev ◽  
...  
Keyword(s):  
Open Surgery ◽  
Intraoperative Complications ◽  
Operation Time ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Laparoscopic Right Hemicolectomy ◽  
End To End ◽  
Median Blood Loss

Aim: to evaluate the results of original manual intracorporeal end-to-end invagination ileotransverse anastomosis after laparoscopic right hemicolectomy.Patients and methods: twenty-two patients with right colon cancer were included in the study: 17 females and 5 males aged 53.1±3.4 years. They underwent laparoscopic right hemicolectomy with the standard D2 lymphadenectomy and intracorporeal ileotransverse anastomosis by the original technique. Follow-up period after surgery was 3 months.Results: no conversions to open surgery occurred. The operation time was 120.0±12.5 minutes, the median blood loss was 87.0±5.0 ml. Twenty (90.9%) patients are still under follow-up. The hospital stay was 11.4±2.6 days. There were no intraoperative complications. There were no cases of anastomotic leakage. No mortality occurred. At the time of the follow-up, all the patients are alive. Two (9.1%) patients have dropped out of control.Conclusion: the experience of the first 22 laparoscopic right hemicolectomies with intracorporeal laparoscopic end-to-end invagination ileotransverse anastomosis makes it possible to recommend this reliably safe method.

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

2019 ◽  
Vol 17 (1) ◽  
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.

scholarly journals Laparoscopic versus Open Transverse-Incision Approach for Right Hemicolectomy: A Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 80
Author(s):  
Claudio F. Feo ◽  
Panagiotis Paliogiannis ◽  
Alessandro Fancellu ◽  
Angelo Zinellu ◽  
Giorgio C. Ginesu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Hospital Stay ◽  
Open Surgery ◽  
Operative Time ◽  
Meta Analysis ◽  
Right Hemicolectomy ◽  
Transverse Incision ◽  
Right Colon ◽  
Right Colon Cancer

Background and Objectives: There is general agreement on the benefits of laparoscopy for treatment of rectal and left colon cancers, whereas findings regarding the comparison of laparoscopic and open right colonic resections are discordant. The aim of this systematic review and meta-analysis was to assess the outcomes and advantages of laparoscopic versus transverse-incision open surgery for management of right colon cancer. Materials and Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Comparative studies evaluating the results of laparoscopic and transverse-incision open right hemicolectomies were analyzed. The measured outcomes were mean operative time, time to feeding, duration of hospital stay, and number of lymph nodes harvested. Results: A total of 5 studies including 318 patients met the inclusion criteria. Meta-analysis revealed no differences in time to resume oral feeding, hospital stay, and number of lymph nodes harvested in between groups, but mean length of surgery was significantly longer in the laparoscopic group. Conclusion: These data confirm that the preferred approach to right hemicolectomy is yet unclear. Laparoscopy has a longer operative time than transverse-incision open surgery, and no significant short-term benefits were observed for the studied parameters. Well-designed randomized control trials (RCTs) might help to identify the differences between these two techniques for the surgical treatment of right colon cancer.

scholarly journals Intra-corporeal delta-shaped anastomosis in laparoscopic right hemicolectomy for right colon cancer: a safe and effective technique

2019 ◽  
Vol 7 (4) ◽  
pp. 272-278
Author(s):  
Hao Su ◽  
Wei-Sen Jin ◽  
Peng Wang ◽  
Mandula Bao ◽  
Xue-Wei Wang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Surgical Outcomes ◽  
Right Hemicolectomy ◽  
Clinicopathological Characteristics ◽  
Complication Rates ◽  
Right Colon ◽  
Short Term ◽  
Right Colon Cancer ◽  
Laparoscopic Right Hemicolectomy ◽  
Operative Recovery

Abstract Background and objective Intra-corporeal delta-shaped anastomosis (IDA) is an important development in laparoscopic digestive-tract reconstruction. We applied it in laparoscopic right hemicolectomy for right colon cancer and compared the short-term outcomes between the patients treated with IDA and conventional extracorporeal anastomosis (EA). Methods Between 1 January 2016 and 1 October 2017, 36 and 50 patients who underwent IDA and EA, respectively, were included. Data on clinicopathological characteristics, surgical outcomes, post-operative recovery and complications were collected and compared between the two groups. Results Surgical outcomes and clinicopathological characteristics were similar between the two groups except the length of incision, which was significantly shorter in the IDA group than in the EA group (4.6 ± 0.6 vs 5.6 ± 0.7 cm, P < 0.001). The time to ground activities, fluid diet intake and post-operative hospitalization did not differ between the groups; however, the time to first flatus was significantly shorter in the IDA group than in the EA group (2.8 ± 0.5 vs 3.2 ± 0.8 days, P = 0.004). The post-operative visual analogue scale for pain was lower in the IDA group than in the EA group on post-operative Day 1 (4.0 ± 0.7 vs 4.5 ± 1.0, P = 0.002) and post-operative Day 3 (2.7 ± 0.6 vs 3.4 ± 0.6, P < 0.001). The surgical complication rates were 8.3 and 16.0% in the IDA and EA groups (P = 0.470), respectively. No complications such as anastomotic bleeding, stenosis and leakage occurred in any patient. Conclusions IDA is safe and feasible and shows more satisfactory short-term outcomes than EA.

scholarly journals New way of laparascopic intracorporeal term-terminal invagination ileotransverse anastomosis

2020 ◽  
pp. 30-35
Author(s):  
M. P. Salamakhin ◽  
O. V. Leonov ◽  
T. S. Dergacheva ◽  
A. O. Soloviev ◽  
D. A. Markelov ◽  
...  
Keyword(s):  
Open Surgery ◽  
Standard Treatment ◽  
Right Hemicolectomy ◽  
D2 Lymph Node Dissection ◽  
Metastatic Lung ◽  
Mechanical Suture ◽  
The Right ◽  
Laparoscopic Hemicolectomy ◽  
Median Blood Loss

Background. Laparoscopic surgery becomes a standard treatment for many surgical diseases. Defects of a stapler laparoscopic mechanical suture during the formation of an anastomosis after hemicolectomy are detected in 18% of observed cases.Objective. Development, substantiate reproducibility and safety of a manual intracorporeal term-terminal invagination ileotransverse anastomosis method after performing the right laparoscopic hemicolectomy.Material and Methods. Authors presented a description of the technique and their own experience of performing laparoscopic hemicolectomy on the right with the formation of a manual original anastomosis in 10 patients with pathology of the right half of the colon. Eight patients (80.0%) had a malignant tumor of the right half of the colon, 1 patient (10.0%) showed multiple polyps of the cecum and the ascending part of the colon, 1 patient (10.0%) developed a cystic-solid submucosa tumor of the ileocecal angle. One patient had metastatic lung disease at the time of establishing diagnosis. The postoperative follow-up period was 7-18 months.Result. There were no conversions to open surgery. All operations (n = 10) were ended completely laparoscopically - right hemicolectomy with standard D2 lymph node dissection. In one patient, we revealed intraoperatively the spread of the tumor to the gallbladder, which required additional cholecystectomy. The duration of the operation was 122.5±10.7 min.; median blood loss was 107±5.2 ml. At the time of follow-up all patients are alive.Conclusion. The technique is universal in the surgical treatment of patients with various pathologies of the right half of the colon.

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

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.

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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