The aim of this prospective clinical study is compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group).
Summary Background Data: Although CME with central vascular ligation in laparoscopic righthemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancerrelated 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use.
Methods:In this randomized controlled trial, several primary endpoints (operative time, intraoperative blood loss, other complications, conversion rate, and anastomotic leak) and secondary endpoints (overall postoperative complications) were evaluated. In addition, we evaluated histopathologic data, including specimen length and the number of lymph nodes harvested, as objective signs of the quality of CME, related to oncological outcomes.
Results:The CME group had a significantly longer mean operative time than the NCME group (216.3 min versus 191.5 min, p=0.005). However, the CME group had a higher number of lymph nodes (23.8 versus 16.6; p<0.001) and larger surgical specimens (34.3 cm versus 29.3 cm; p=0002). No differences were reported with respect to intraoperative blood loss, conversion rate, leakage, or other postoperative complications.
Conclusions:In this study laparoscopic CME were a safe and feasible technique with improvement in lymph nodes harvesting and length of surgical specimens with no increase of surgical intraoperative and postoperative complications.