Achieving high quality standards in laparoscopic colon resection for cancer: A Delphi consensus-based position paper

Lorenzon, Laura; Biondi, Alberto; Carus, Thomas; Dziki, Adam; Espín, Eloy; Figueiredo, Nuno; Ruiz, Marcos Gómez; Mersich, Tamás; Montroni, Isacco; Tanis, Pieter J.; Benz, Stefan; Bianchi, Paolo Pietro; Biebl, Matthias; Broeders, I. A. M. J.; Luca, Raffaele De; Delrio, Paolo; D’Hondt, Mathieu; Fürst, Alois; Grosek, Jan; Videira, José Flávio; Herbst, F.; Jayne, David; Lázár, György; Mišković, Danilo; Muratore, Andrea; Sjö, O.; Scheinin, Tom; Tomažič, Aleš; Türler, Andreas; Velde, C. van de; Wexner, Steven D.; Wullstein, C.; Zegarski, Wojciech; D’Ugo, Domenico

doi:10.1016/j.ejso.2018.01.091

Cited by 22 publications

(20 citation statements)

References 60 publications

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“…With the development and innovation of surgical techniques, the prognosis of patients with colon cancer seems to have improved. However, these new surgical technologies have not been fully adopted (16,17). Concurrently, large clinical trials using targeted therapies have been performed worldwide (4,18,19), to nd treatments that could effectively improve patient prognosis and inhibit colon cancer metastasis.…”

Section: Discussionmentioning

confidence: 99%

CCDC12 Promotes Tumor Development and Invasion Through the Snail Pathway in Colon Adenocarcinoma

Wang

et al. 2020

Preprint

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Background: To determine the role of Coiled-coil domain containing 12 (CCDC12) in colon adenocarcinoma (COAD).Methods: We used integrative expression Quantitative Trait Loci (eQTL) analysis to identify risk single nucleotide polymorphisms (SNPs) and associated genes. Immunohistochemical staining (IHC) and western blotting (WB) were used to detect CCDC12 expression. We selected SW480 and LOVO cell lines to knock down CCDC12, while HCT116 and SW480-KD cell lines were up-regulated. Then performed functional studies and established a xenograft tumor model in BALB/c mice. Four plex Isobaric Tags for Relative and Absolute Quantitation (iTRAQ) assays were performed to determine its function and potential regulatory mechanism. Overexpressed Snail and knocked down CCDC12 subsequently in SW480 cells to find them association.Results: Integrative eQTL analysis found that rs8180040 was significantly associated with CCDC12 in COAD patients. IHC and WB confirmed CCDC12 was highly expressed in COAD tissues (IHC 51/75 vs 8/75, WB 10/12 vs 2/12). This was consistent with RNA-Seq data from TCGA database (P value < 0.001). Knockdown of CCDC12 could significantly reduce proliferation, migration, invasion and tumorigenicity of colon cancer cells, while exogenous overexpression of CCDC12 had the opposite effect. iTRAQ assays demonstrated that overexpression of CCDC12 would change proteins on adherens junction pathway. Overexpression of Snail did not significantly change CCDC12 levels in SW480 cells, while knock down of CCDC12 reduced that of Snail.Conclusions: CCDC12 plays a significant role in tumorigenesis, development and invasion of COAD and may affect the epithelial to mesenchymal transformation process of colon cancer cells by regulating the Snail pathway.

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Section: Discussionmentioning

confidence: 99%

CCDC12 Promotes Tumor Development and Invasion Through the Snail Pathway in Colon Adenocarcinoma

Wang

et al. 2020

Preprint

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“…In this multicentre international study, two thirds of patients underwent a planned laparoscopic operation. This is one of the highest rates described worldwide showing the high implementation of laparoscopic approach in contemporary practice . This study did not collect data on previous surgery or size or stage of lesion resection, which may have indicated that an open operation in the first instance was entirely appropriate.…”

Section: Discussionmentioning

confidence: 99%

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit

Pool¹,

Rawlings²,

Kuiper³

et al. 2018

Colorectal Disease

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Background Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. Methods Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30‐day major complication rate, defined as Clavien‐Dindo grade III‐V. Results Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27–2.11, P < 0.001). Conclusions Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection.

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“…The secondary outcomes were time to first flatus (TFF) and time to first stool (TFS) evacuation. The exposure was the robotic technique; the control was the laparoscopic technique, the current standard treatment for carcinoma or endoscopically unresectable adenoma of the right colon[ 14 ]. Routine demographic variables were obtained, including age at time of surgery and gender.…”

Section: Methodsmentioning

confidence: 99%

Robotic vs laparoscopic right colectomy – the burden of age and comorbidity in perioperative outcomes: An observational study

Tagliabue¹,

Burati²,

Chiarelli³

et al. 2020

WJGS

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BACKGROUND Several studies have shown the safety, feasibility and oncologic adequacy of robotic right hemicolectomy (RRH). Laparoscopic right hemicolectomy (LRH) is considered technically challenging. Robotic surgery has been introduced to overcome this technical limitation, but it is related to high costs. To maximize the benefits of such surgery, only selected patients are candidates for this technique. In addition, due to progressive aging of the population, an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities, who are usually more prone to post-operative complications. AIM To investigate the outcomes of RRH vs LRH with regard to age and comorbidities. METHODS We retrospectively analyzed 123 minimally invasive procedures (68 LRHs vs 55 RRHs) for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September 2019. The surgical procedures were performed according to standardized techniques. The primary clinical outcome of the study was the length of hospital stay (LOS) measured in days. Secondary outcomes were time to first flatus (TFF) and time to first stool evacuation. The robotic technique was considered the exposure and the laparoscopic technique was considered the control. Routine demographic variables were obtained, including age at time of surgery and gender. Body mass index and American Society of Anesthesiologists physical status were registered. The age-adjusted Charlson Comorbidity Index (ACCI) was calculated; the tumor-node-metastasis system, intra-operative variables and post-operative complications were recorded. Post-operative follow-up was 180 d. RESULTS LOS, TFF, and time to first stool were significantly shorter in the robotic group: Median 6 [interquartile range (IQR) 5-8] vs 7 (IQR 6-10.5) d, P = 0.028; median 2 (IQR 1-3) vs 3 (IQR 2-4) d, P < 0.001; median 4 (IQR 3-5) vs 5 (IQR 4-6.5) d, P = 0.005, respectively. Following multivariable analysis, the robotic technique was confirmed to be predictive of significantly shorter hospitalization and faster restoration of bowel function; in addition the dichotomous variables of age over 75 years and ACCI more than 7 were significant predictors of hospital stay. No outcomes were significantly associated with Clavien-Dindo grading. Sub-group analysis demonstrated that patients aged over 75 years had a longer LOS (median 6 -IQR 5-8- vs 7 -IQR 6-12- d, P = 0.013) and later TFF (median 2 -IQR 1-3- vs 3 -IQR 2-4- d, P = 0.008), while patients with ACCI more than 7 were only associated with a prolonged hospital stay (median...

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Achieving high quality standards in laparoscopic colon resection for cancer: A Delphi consensus-based position paper

Abstract: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology.

Cited by 22 publications

References 60 publications

CCDC12 Promotes Tumor Development and Invasion Through the Snail Pathway in Colon Adenocarcinoma

CCDC12 Promotes Tumor Development and Invasion Through the Snail Pathway in Colon Adenocarcinoma

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit

Robotic vs laparoscopic right colectomy – the burden of age and comorbidity in perioperative outcomes: An observational study

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