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Laparoscopic complete mesocolic excision via combined medial and cranial approaches for transverse colon cancer

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Abstract

Purpose

To evaluate the safety and feasibility of laparoscopic complete mesocolic excision via combined medial and cranial approaches with three-dimensional visualization around the gastrocolic trunk and middle colic vessels for transverse colon cancer.

Methods

We evaluated prospectively collected data of 30 consecutive patients who underwent laparoscopic complete mesocolic excision between January 2010 and December 2015, 6 of whom we excluded, leaving 24 for the analysis. We assessed the completeness of excision, operative data, pathological findings, length of large bowel resected, complications, length of hospital stay, and oncological outcomes.

Results

Complete mesocolic excision completeness was graded as the mesocolic and intramesocolic planes in 21 and 3 patients, respectively. Eleven, two, eight, and three patients had T1, T2, T3, and T4a tumors, respectively; none had lymph node metastases. A mean of 18.3 lymph nodes was retrieved, and a mean of 5.4 lymph nodes was retrieved around the origin of the MCV. The mean large bowel length was 21.9 cm, operative time 274 min, intraoperative blood loss 41 mL, and length of hospital stay 15 days. There were no intraoperative and two postoperative complications.

Conclusion

Our procedure for laparoscopic complete mesocolic excision via combined medial and cranial approaches is safe and feasible for transverse colon cancer.

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Acknowledgments

The authors deeply appreciate the contributions of all of the surgeons, coworkers, and friends who participated in this study and thank the editors and reviewers for their help with this manuscript.

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Authors and Affiliations

  1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan

    Shinichiro Mori, Yoshiaki Kita, Kenji Baba, Masayuki Yanagi, Kan Tanabe, Yasuto Uchikado, Hiroshi Kurahara, Takaaki Arigami, Yoshikazu Uenosono, Yuko Mataki, Hiroshi Okumura, Akihiro Nakajo, Kosei Maemura & Shoji Natsugoe

Authors
  1. Shinichiro Mori
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  2. Yoshiaki Kita
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  3. Kenji Baba
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  4. Masayuki Yanagi
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  5. Kan Tanabe
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  6. Yasuto Uchikado
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  7. Hiroshi Kurahara
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  8. Takaaki Arigami
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  9. Yoshikazu Uenosono
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  10. Yuko Mataki
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  11. Hiroshi Okumura
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  13. Kosei Maemura
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  14. Shoji Natsugoe
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Correspondence to Shinichiro Mori.

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The authors declare no conflicts of interest in association with this study.

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Mori, S., Kita, Y., Baba, K. et al. Laparoscopic complete mesocolic excision via combined medial and cranial approaches for transverse colon cancer. Surg Today 47, 643–649 (2017). https://doi.org/10.1007/s00595-016-1409-2

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  • DOI: https://doi.org/10.1007/s00595-016-1409-2

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