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

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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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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Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, Colorectal Cancer Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Sung Uk Bae MD, Avanish P. Saklani MD, Dae Ro Lim MD, Hyuk Hur MD, Byung Soh Min PhD, Seung Hyuk Baik PhD, Kang Young Lee PhD & Nam Kyu Kim MD, PhD, FACS

  2. Biostatistics Collaboration Unit, Yonsei University, Seoul, Korea

    Dong Wook Kim PhD

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  1. Sung Uk Bae MD
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  2. Avanish P. Saklani MD
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Correspondence to Nam Kyu Kim MD, PhD, FACS.

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Bae, S.U., Saklani, A.P., Lim, D.R. et al. Laparoscopic-Assisted Versus Open Complete Mesocolic Excision and Central Vascular Ligation for Right-Sided Colon Cancer. Ann Surg Oncol 21, 2288–2294 (2014). https://doi.org/10.1245/s10434-014-3614-9

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  • DOI: https://doi.org/10.1245/s10434-014-3614-9

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