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Standardized Laparoscopic Intracorporeal Right Colectomy for Cancer: Short-Term Outcome in 111 Unselected Patients

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Diseases of the Colon & Rectum

Abstract

Purpose

This study was designed to evaluate the impact of a standardized laparoscopic intracorporeal right colectomy on the short-term outcome of patients with neoplasia.

Methods

Consecutive patients with histologically proven right colon neoplasia underwent a standardized laparoscopic intracorporeal right colectomy with medial to lateral approach encompassing ten sequential steps: 1) ligation of ileocolic vessels, 2) identification of right ureter, 3) dissection along superior mesenteric vein, 4) division of omentum, 5) division of right branch of middle colic vessels, 6) transection of transverse colon, 7) mobilization of right colon, 8) transection of terminal ileum, 9) ileocolic anastomosis, 10) delivery of specimen. Values were medians (ranges).

Results

From July 2002 to June 2005, 111 laparoscopic intracorporeal right colectomies were attempted with a 5.4 percent conversion rate. There were 57 women and 54 men, aged 64.9 (range, 40–85) years, with body mass index of 33 (range, 20–43), American Society of Anesthesiology score of 2 (range, 2–4), 36.9 percent comorbidities, and 37.8 percent previous abdominal surgery. The indication for surgery was cancer in 109 patients. Operative time was 120 (range, 80–185) minutes. Estimated blood loss was 69 (range, 50–600) ml. Overall length of skin incisions was 66 (range, 60–66) mm; 29 (range, 2–41) lymph nodes were harvested. Length of stay was four (range, 2–30) days. Complication rate was 4.5 percent.

Conclusions

A standardized laparoscopic intracorporeal right colectomy resulted in a favorable short-term outcome in unselected patients with neoplasia of the right colon.

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References

  1. Schlinkert RT. Laparoscopic-assisted right hemicolectomy. Dis Colon Rectum 1991;34:1030–1.

    Article  PubMed  CAS  Google Scholar 

  2. Young-Fadok TM, Nelson H. Laparoscopic right colectomy: five-step procedure. Dis Colon Rectum 2000;43:267–73.

    Article  PubMed  CAS  Google Scholar 

  3. Senagore AJ, Delaney CP, Brady KM, Fazio VW. Standardized approach to laparoscopic right colectomy: outcomes in 70 consecutive cases. J Am Coll Surg 2004;199:675–9.

    Article  PubMed  Google Scholar 

  4. Bohm B, Milsom JW, Kitago K, Brand M, Stolfi VM, Fazio VW. Use of laparoscopic techniques in oncologic right colectomy in a canine model. Ann Surg Oncol 1995;2:6–13.

    Article  PubMed  CAS  Google Scholar 

  5. Casciola L, Ceccarelli G, Di Zitti L, et al. Laparoscopic right hemicolectomy with intracorporeal anastomosis. Technical aspects and personal experience. Minerva Chir 2003;58:621–7.

    PubMed  CAS  Google Scholar 

  6. Bernstein MA, Dawson JW, Reissman P, Weiss EG, Nogueras JJ, Wexner SD. Is complete laparoscopic colectomy superior to laparoscopic assisted colectomy? Am Surg 1996;62:507–11.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  8. Toyota S, Ohta H, Anazawa S. Rationale for extent of lymph node dissection for right colon cancer. Dis Colon Rectum 1995;38:705–11.

    Article  PubMed  CAS  Google Scholar 

  9. Jin G, Tuo H, Sugiyama M, et al. Anatomic study of the superior right colic vein: its relevance to pancreatic and colonic surgery. Am J Surg 2006;191:100–3.

    Article  PubMed  Google Scholar 

  10. Goldstein NS, Sanford W, Coffey M, Layfield LJ. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered. Am J Clin Pathol 1996;106:209–16.

    PubMed  CAS  Google Scholar 

  11. Monson JR. Invited Editorial. Dis Colon Rectum 2000;43:271–2.

    Article  Google Scholar 

  12. Ignjatovic D, Stimec B, Finnjord T, Bergamaschi R. Venous anatomy of the right colon: 3D topographic mapping of the gastrocolic trunk of Henle. Tech Coloproctol 2004;8:19–21.

    Article  PubMed  CAS  Google Scholar 

  13. 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  PubMed  CAS  Google Scholar 

  14. Raftopoulos I, Courcoulas AP, Blumberg D. Should completely intracorporeal anastomosis be considered in obese patients who undergo laparoscopic colectomy for benign or malignant disease of the colon? Surgery 2006;140:675–82.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Roberto Bergamaschi M.D., Ph.D..

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Bergamaschi, R., Schochet, E., Haughn, C. et al. Standardized Laparoscopic Intracorporeal Right Colectomy for Cancer: Short-Term Outcome in 111 Unselected Patients. Dis Colon Rectum 51, 1350–1355 (2008). https://doi.org/10.1007/s10350-008-9341-1

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  • DOI: https://doi.org/10.1007/s10350-008-9341-1

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