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Annals of Surgical Oncology

, Volume 21, Issue 7, pp 2288–2294 | Cite as

Laparoscopic-Assisted Versus Open Complete Mesocolic Excision and Central Vascular Ligation for Right-Sided Colon Cancer

  • Sung Uk Bae
  • Avanish P. Saklani
  • Dae Ro Lim
  • Dong Wook Kim
  • Hyuk Hur
  • Byung Soh Min
  • Seung Hyuk Baik
  • Kang Young Lee
  • Nam Kyu Kim
Colorectal Cancer

Abstract

Background

A concept of complete mesocolic excision (CME) and central vascular ligation for colonic cancer has been recently introduced. The aim of this study was to evaluate and compare perioperative and oncologic outcomes after laparoscopic-assisted CME (LCME) and open CME (OCME) for right-sided colon cancers.

Methods

The study group included 128 patients who underwent an LCME and 137 patients who underwent an OCME for right-sided colon cancer between June 2006 and December 2008. The propensity scoring matching for sex, body mass index, tumor location, and pathologic T and TNM stage produced 85 matched pairs.

Results

The median time to soft diet (LCME 6 days vs. OCME 7 days, p < 0.001) and the possible length of stay (7 vs. 13 days, p < 0.001) were significantly shorter in the laparoscopic group. The median operation time (179 vs. 194 minutes, p = 0.862) and number of harvested lymph nodes (27 vs. 28, p = 0.337) were comparable between groups. The morbidity within 30 days after surgery was comparable between the groups (12.9 vs. 24.7 %, p = 0.050). The 5-year overall survival rates of the OCME and LCME groups were 77.8 and 90.3 % (p = 0.028), and the 5-year disease-free survival rates were 71.8 and 83.3 % (p = 0.578), respectively.

Conclusions

Herein, we demonstrated the feasibility and safety of LCME for right-sided colon cancer, and in terms of better short-term outcomes, LCME was more advantageous than OCME. Although LCME for right-sided colon cancer was associated with better 5-year overall survival, compared with an open approach, the long-term oncologic outcomes between the groups were comparable.

Keywords

Overall Survival Propensity Score Open Group Total Mesorectal Excision Laparoscopic Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This work was supported by the Student’s Association of the Graduate School of Yonsei University funded by the Graduate School of Yonsei University.

Disclosures

The authors have nothing to disclose.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Sung Uk Bae
    • 1
  • Avanish P. Saklani
    • 1
  • Dae Ro Lim
    • 1
  • Dong Wook Kim
    • 2
  • Hyuk Hur
    • 1
  • Byung Soh Min
    • 1
  • Seung Hyuk Baik
    • 1
  • Kang Young Lee
    • 1
  • Nam Kyu Kim
    • 1
  1. 1.Division of Colorectal Surgery, Department of Surgery, Colorectal Cancer Clinic, Severance HospitalYonsei University College of MedicineSeoulKorea
  2. 2.Biostatistics Collaboration UnitYonsei UniversitySeoulKorea

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