Autologous blood for preoperative colorectal TUMOR's localization: A Vietnamese preliminary experience

Nguyen, Ngoc Hung; Nguyen, The Hiep; Nguyen, Cong Long; Vu, Xuan Vinh; Luong, Tuan Hiep; Nguyen, Thanh Khiem

doi:10.1016/j.amsu.2022.103345

Cited by 3 publications

(1 citation statement)

References 19 publications

(24 reference statements)

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“…Twenty-two cases (68.8%) of tumors were at T3-Stage, and there were correspondingly twenty-seven cases (84.4%) of tumors which were at Stage II-III according to AJCC 8 th Cancer Staging. There was one case of T1-Stage, and in this case, the tumor location was preoperatively identi ed by autologous blood marking [19].…”

Section: Resultsmentioning

confidence: 99%

Bach Mai Procedure with Combining Approach and Early Resection of The Terminal Ileum for Total Laparoscopic Right Hemicolectomy: A prospective study

Nguyen

et al. 2023

Preprint

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Purpose. Total laparoscopic right hemicolectomy with complete mesocolic excision (CME), central vascular ligation (CVL) and D3 lymphadenectomy is still the most challenging colon procedures for gastrointestinal surgeons. We herein report the technical details and our preliminary experience of Bach Mai Procedure - a novel combining approach and early resection of the terminal ileum. Methods. The Dissection Stage was central vascular isolation and ligation by a combined multiple approaches in the following four steps: (Cranial approach) dissecting along the inferior aspect of pancreatic isthmus to reveal the middle colic vessels and the anterior aspect of the superior mesentery vein, then exposed the right gastroepiploic vein and the trunk of Henle; (Medial-to-lateral approach) exposing the surgical axis - the superior mesenteric vascular axis, then early resection of the terminal ileum to open the dissection from the bottom up; (Caudal approach) radical ligation of the ileocecal artery and right colic artery (central vascular ligation), lymph node dissection (D3 lymphadenectomy) and (Lateral-to-medial approach) resecting the Toldt fascia of the colon to release the entire right colon from the abdominal wall. Results. In 12 months, there were 32 cases of primary right-sided colon malignancies that have undergone tLRHD3, CME/CVL based on the novel combining approach and early resection of the terminal ileum. In 3 cases (9.4%), the tumor site was hepatic flexure. The median of lymph node number (LNN) was 38, with the maximum number was 101. No serious postoperative complications (grade III or higher) neither in-hospital mortality was detected. Conclusion. This novel combining approach and early resection of the terminal ileum is technically feasible and safe for tLRHD3, CME/CVL. Further investigations and follow-up must be proceeded to evaluate the long-term outcomes of our technique.

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Section: Resultsmentioning

confidence: 99%

Bach Mai Procedure with Combining Approach and Early Resection of The Terminal Ileum for Total Laparoscopic Right Hemicolectomy: A prospective study

Nguyen

et al. 2023

Preprint

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Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial

Zhang

et al. 2023

BMC Cancer

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Background Laparoscopic colorectal surgery has been proved to have similar oncological outcomes with open surgery. Due to the lack of tactile perception, surgeons may have misjudgments in laparoscopic colorectal surgery. Therefore, the accurate localization of a tumor before surgery is important, especially in the early stages of cancer. Autologous blood was thought a feasible and safe tattooing agent for preoperative endoscopic localization but its benefits remain controversial. We therefore proposed this randomized trial to the accuracy and safety of autogenous blood localization in small, serosa-negative lesion which will be resected by laparoscopic colectomy. Methods The current study is a single-center, open-label, non-inferiority, randomized controlled trial. Eligible participants would be aged 18–80 years and diagnosed with large lateral spreading tumors that could not be treated endoscopically, malignant polyps treated endoscopically that required additional colorectal resection, and serosa-negative malignant colorectal tumors (≤ cT3). A total of 220 patients would be randomly assigned (1:1) to autologous blood group or intraoperative colonoscopy group. The primary outcome is the localization accuracy. The secondary endpoint is adverse events related to endoscopic tattooing. Discussion This trial will investigate whether autologous blood marker achieves similar localization accuracy and safety in laparoscopic colorectal surgery compared to intraoperative colonoscopy. If our research hypothesis is statistically proved, the rational introduction of autologous blood tattooing in preoperative colonoscopy can help improve identification of the location of tumors for laparoscopic colorectal cancer surgery, performing an optimal resection, and minimizing unnecessary resections of normal tissues, thereby improving the patient’s quality of life. Our research data will also provide high quality clinical evidence and data support for the conduction of multicenter phase III clinical trials. Trial registration This study is registered with ClinicalTrials.gov, NCT05597384. Registered 28 October 2022

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Bach Mai Procedure for complete mesocolic excision, central vascular ligation, and D3 lymphadenectomy in total laparoscopic right hemicolectomy: a prospective study

Nguyen

et al. 2023

World J Surg Onc

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Purpose Total laparoscopic right hemicolectomy with complete mesocolic excision (CME), central vascular ligation (CVL), and D3 lymphadenectomy is still the most challenging colon procedures for gastrointestinal surgeons. We herein report the technical details and our preliminary experience of Bach Mai Procedure — a novel-combining (cranial, medial to lateral, and caudal) approach with early resection of the terminal ileum. Methods The dissection stage was central vascular isolation and ligation by a combined multiple approaches in the following four steps: cranial approach, dissecting along the inferior aspect of pancreatic isthmus to reveal the middle colic vessels and the anterior aspect of the superior mesentery vein and then exposed the right gastroepiploic vein and the trunk of Henle; medial-to-lateral approach, exposing the surgical axis — the superior mesenteric vascular axis and then early resection of the terminal ileum to open the dissection from the bottom up; and caudal approach, radical ligation of the ileocecal artery and right colic artery (central vascular ligation), lymph node dissection (D3 lymphadenectomy), and resecting the Toldt fascia of the colon to release the entire right colon from the abdominal wall. Results In 12 months, there were 32 cases of primary right-sided colon malignancies that have undergone tLRHD3, CME/CVL based on the Bach Mai Procedure. In 3 cases (9.4%), the tumor site was hepatic flexure. The median of lymph node number (LNN) was 38, with the maximum number which was 101. No serious postoperative complications (grade 3 or higher) neither inhospital mortality was detected. Conclusion This Bach Mai procedure, a novel-combining approach with early resection of the terminal ileum, is technically feasible and safe for tLRHD3, CME/CVL. Further investigations and follow-up must be proceeded to evaluate the long-term outcomes of our technique.

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Autologous blood for preoperative colorectal TUMOR's localization: A Vietnamese preliminary experience

Cited by 3 publications

References 19 publications

Bach Mai Procedure with Combining Approach and Early Resection of The Terminal Ileum for Total Laparoscopic Right Hemicolectomy: A prospective study

Bach Mai Procedure with Combining Approach and Early Resection of The Terminal Ileum for Total Laparoscopic Right Hemicolectomy: A prospective study

Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial

Bach Mai Procedure for complete mesocolic excision, central vascular ligation, and D3 lymphadenectomy in total laparoscopic right hemicolectomy: a prospective study

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