Skip to main content

Advertisement

SpringerLink
Log in

Long-term outcome of laparoscopic-assisted right-hemicolectomy with D3 lymphadenectomy versus open surgery for colon carcinoma

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To investigate the applicability, safety, short-term and long-term outcomes of laparoscopic surgery in the treatment of right-sided colon carcinomas with D3 lymphadenectomy.

Methods

Between June 2003 and September 2010, 324 patients with right-sided colon carcinoma underwent surgical treatment in the same hospital, 177 cases were treated by laparoscopic surgery (LRH group) and 147 cases by open surgery (ORH group). We performed a retrospective analysis of the differences between the two groups in terms of the clinical data.

Results

There were no significant differences between the two groups in the demographic data; however, the recovery time was significantly shorter in the LRH group, the number of overall lymph nodes harvested and principle lymph nodes harvested in the LRH group was significantly higher than in the ORH group, the incidence of postoperative complications was 12.99 % in the LRH group and 22.45 % in the ORH group (P < 0.05), and the recurrence rate in the LRH group was lower than that in the ORH group, although the difference was not significant (15.25 vs 19.73 %). The cumulative overall survival for all stages at 1, 3 and 5 years in the LRH group (97.18, 83.73 and 70.37 %) were not significantly different compared to those in the ORH group (94.56, 77.84 and 66.97 %).

Conclusions

Laparoscopic-assisted right hemicolectomy with D3 lymphadenectomy for colon carcinomas is safe and effective, while it is also superior to open surgery regarding the short-term outcomes, and the long-term outcomes are similar to those of open surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc. 1991;1:144–50.

    CAS  PubMed  Google Scholar 

  2. Lee SD, Lim SB. D3 lymphadenectomy using a medial to lateral approach for curable right-sided colon cancer. Int J Colorectal Dis. 2009;24:295–300.

    Article  PubMed  Google Scholar 

  3. Liang JT, Lai HS, Lee PH. Laparoscopic medial-to-lateral approach for the curative resection of right-sided colon cancer. Ann Surg Oncol. 2007;14:1878–9.

    Article  PubMed  Google Scholar 

  4. Japanese society for cancer of the colon and rectum. Japanese Classification of Colorectal Carcinoma. Tokyo: Kanehara & Co 1997.

  5. Zheng MH, Feng B, Lu AG, Li JW, Wang ML, Mao ZH, et al. Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma. World J Gastroenterol. 2005;11:323–6.

    PubMed  Google Scholar 

  6. Tan WS, Chew MH, Ooi BS, Ng KH, Lim JF, Ho KS, et al. Laparoscopic versus open right hemicolectomy: a comparison of short-term outcomes. Int J Colorectal Dis. 2009;23:234–7.

    Google Scholar 

  7. Kim HJ, Lee IK, Lee YS, Kang WK, Park JK, Oh ST, et al. A comparative study on the short-term clinicopathologic outcomes of laparoscopic surgery versus conventional open surgery for transverse colon cancer. Surg Endosc. 2009;23:1812–7.

    Article  CAS  PubMed  Google Scholar 

  8. Liang JT, Huang KC, Lai HS, Lee PH, Sun CT. Oncologic results of laparoscopic D3 lymphadenectomy for male sigmoid and upper rectal cancer with clinically positive lymph nodes. Ann Surg Oncol. 2007;14:1980–90.

    Article  PubMed  Google Scholar 

  9. Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J. Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials. Cancer Treat Rev. 2008;34:498–504.

    Article  PubMed  Google Scholar 

  10. Tong DK, Law WL. Laparoscopic versus open right hemicolectomy for carcinoma of the colon. JSLS. 2007;11:76–80.

    PubMed Central  PubMed  Google Scholar 

  11. Li JC, Leung KL, Ng SS, Liu SY, Lee JF, Hon SS. Laparoscopic-assisted versus open resection of right-sided colonic cancer-a prospective randomized controlled trial. Int J Colorectal Dis. 2012;27:95–102.

    Article  PubMed  Google Scholar 

  12. Konishi F, Okada M, Nagai H, Ozawa A, Kashiwagi H, Kanazawa K. Laparoscopic-assisted colectomy with lymph node dissection for invasive carcinoma of the colon. Surg Today. 1996;26:882–9.

    Article  CAS  PubMed  Google Scholar 

  13. Shatari T, Fujita M, Nozawa K, Haku K, Niimi M, Ikeda Y, et al. Vascular anatomy for right colon lymphadenectomy. Surg Radiol Anat. 2003;25:86–8.

    Article  CAS  PubMed  Google Scholar 

  14. Ignjatovic D, Sund S, Stimec B, Bergamaschi R. Vascular relationships in right colectomy for cancer clinical implications. Tech Colproctol. 2007;11:247–50.

    Article  CAS  Google Scholar 

  15. West NP, Morris EJ, Rotimi O, Cairns A, Finan PJ, Quirke P. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol. 2008;9:857–65.

    Article  PubMed  Google Scholar 

  16. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Colorectal Dis. 2009;11:354–64.

    Article  CAS  PubMed  Google Scholar 

  17. West NP, Kobayashi H, Takahashi K, Perrakis A, Weber K, Hohenberger W, et al. Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol. 2012;30:1763–9.

    Article  PubMed  Google Scholar 

  18. Leung KL, Meng WC, Lee JF, Thung KH, Lai PB, Lau WY. Laparoscopic-assisted resection of right-sided colonic carcinoma: a case–control study. J Surg Oncol. 1999;71:97–100.

    Article  CAS  PubMed  Google Scholar 

  19. Tekkis PP, Senagore AJ, Delaney CP, Fazio VW. Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg. 2005;242:83–91.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Colon Cancer Laparoscopic or Open Resection Study Group, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10:44–52.

    Article  PubMed  Google Scholar 

  21. Feng B, Zheng MH, Mao ZH, Li JW, Lu AG, Wang ML, et al. Clinical advantages of laparoscopic colorectal cancer surgery in the elderly Aging. Clin Exp Res. 2006;18:191–5.

    Article  Google Scholar 

  22. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg. 2007;246:662–4.

    Article  Google Scholar 

  23. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol. 2007;25:3061–8.

    Article  PubMed  Google Scholar 

  24. Nakamura T, Onozato W, Mitomi H, Naito M, Sato T, Ozawa H, et al. Retrospective, matched case–control study comparing the oncologic outcomes between laparoscopic surgery and open surgery in patients with right-sided colon cancer. Surg Today. 2009;39:1040–5.

    Article  CAS  PubMed  Google Scholar 

  25. Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359:2224–9.

    Article  PubMed  Google Scholar 

  26. Kitano S, Kitajima M, Konishi F, Kondo H, Satomi S, Shimizu N, et al. A multicenter study on laparoscopic surgery for colorectal cancer in Japan. Surg Endosc. 2006;20:1348–52.

    Article  CAS  PubMed  Google Scholar 

  27. Bertelsen CA, Bols B, Ingeholm P, Jansen JE, Neuenschwander AU, Vilandt J. Can the quality of colonic surgery be improved by standardization of surgical technique with complete mesocolic excision? Colorectal Dis. 2011;13:1123–9.

    Article  CAS  PubMed  Google Scholar 

  28. West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 2010;28:272–8.

    Article  PubMed  Google Scholar 

  29. West NP, Sutton KM, Ingeholm P, Hagemann-Madsen RH, Hohenberger W, Quirke P. Improving the quality of colon cancer surgery through a surgical education program. Dis Colon Rectum. 2010;53:1594–603.

    Article  PubMed  Google Scholar 

  30. Feng B, Sun J, Ling TL, Lu AG, Wang ML, Chen XY, et al. Laparoscopic complete mesocolic excision (CME) with medial access for right-hemi colon cancer: feasibility and technical strategies. Surg Endosc. 2012. doi:10.1007/s00464-012-2435-9.

    Google Scholar 

Download references

Acknowledgments

We are grateful to Dr. Ming-Liang Wang (Ruijin Hospital, Shanghai Jiaotong University School of Medicine; Shanghai; China) for his valuable academic support.

Conflict of interest

Drs. Ding-Pei Han, Ai-Guo Lu, Hao Feng, Pu-Xiong-Zhi Wang, Qi-Feng Cao, Ya-Ping Zong, Bo Feng, Min-Hua Zheng have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China

    Ding-Pei Han, Ai-Guo Lu, Hao Feng, Pu-Xiong-Zhi Wang, Qi-Feng Cao, Ya-Ping Zong & Bo Feng

  2. Minhang Branch of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China

    Min-Hua Zheng

  3. Shanghai Minimally Invasive Surgery Center, Shanghai, 200025, China

    Ding-Pei Han, Ai-Guo Lu, Hao Feng, Pu-Xiong-Zhi Wang, Qi-Feng Cao, Ya-Ping Zong, Bo Feng & Min-Hua Zheng

Authors
  1. Ding-Pei Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ai-Guo Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hao Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pu-Xiong-Zhi Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qi-Feng Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ya-Ping Zong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bo Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Min-Hua Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Min-Hua Zheng.

Additional information

D.-P. Han and A.-G. Lu contributed equally to this work as first authors.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Han, DP., Lu, AG., Feng, H. et al. Long-term outcome of laparoscopic-assisted right-hemicolectomy with D3 lymphadenectomy versus open surgery for colon carcinoma. Surg Today 44, 868–874 (2014). https://doi.org/10.1007/s00595-013-0697-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-013-0697-z

Keywords

Search

Navigation