Abstract
Background
Complete mesocolic excision with central vessel ligation may be important for accurate staging and improving the prognosis of right-sided colon cancer. Although the procedure is often performed laparoscopically, approaching the middle colic artery (MCA) is technically demanding, especially when complete ligation of arteries at their roots is desired. We standardized our laparoscopic approach by establishing the dissection boundary along the superior mesenteric artery to achieve D3 lymphadenectomy in the region of the MCA. The aim of the present study was to evaluate, on the basis of perioperative and short-term oncologic outcomes, the feasibility and safety of our technique
Methods
We conducted a retrospective study on consecutive patients with cancer located at the ascending colon and transverse colon who had laparoscopic right hemicolectomy requiring ligation of the MCA.
Results
There were 41 patients (22 males, median age 71 years [range 49–86] years). The median operation time was 285 min, and blood loss volume was 40 mL. Conversion to open surgery was required in 1 case. Complications that were Clavien–Dindo grade III or above occurred in 3 patients (7.3%). There was no anastomotic leakage. The median number of lymph nodes harvested was 46.
Conclusions
Our technique was shown to be a safe, feasible, and useful strategy for performance of right hemicolectomy requiring ligation of the MCA in cases of colon cancer. The technique facilitates maximal lymph node dissection. Having obtained favorable outcomes, we look forward to investigation into long-term outcomes.
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No special funding was received for this study.
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The study was approved by the institutional review board of Kanagawa Cancer Center (Approval No. 2018EKI-128), and the work complied with the current laws in Japan.
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All patients included in the study had provided written, informed consent for the use of their clinical information for study purposes.
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Sato, S., Sugano, N., Shiozawa, M. et al. Application and outcomes of a standardized lymphadenectomy in laparoscopic right hemicolectomy requiring ligation of the middle colic artery. Tech Coloproctol 25, 223–227 (2021). https://doi.org/10.1007/s10151-020-02388-2
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DOI: https://doi.org/10.1007/s10151-020-02388-2