Laparoscopic Colectomy

Rotholtz, Nicolás A.; Bun, Maximiliano; Tessio, Margarita; Lencinas, Sandra; Laporte, Mariano; Aued, María Laura; Peczan, Carlos; Mezzadri, Norberto A

doi:10.1097/sle.0b013e31818e91f3

Cited by 32 publications

(16 citation statements)

References 25 publications

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“…The operative approach of CME includes lateral or medial access. According to the literature, lateral access or medial access is used to conduct CME procedures [ 24 25 ]. For right hemicolectomies, lateral access is usually performed in most open surgeries, whereas medial access is used in most laparoscopic approaches.…”

Section: Discussionmentioning

confidence: 99%

Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches

et al. 2017

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PurposeTo demonstrate the feasibility, safety, and technical strategies of hand-assisted laparoscopic complete mesocolic excision (HAL-CME) and to compare oncological outcomes between HAL-CME and the open approach (O-CME) for right colon cancers.MethodsPatients who were scheduled to undergo a right hemicolectomy were divided into HAL-CME and O-CME groups. Measured outcomes included demographic variables, perioperative parameters, and follow-up data. Demographic variables included age, sex distribution, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status classification, previous abdominal surgery, tumor localization, and potential comorbidities. Perioperative parameters included incision length, operative time, blood loss, conversion rate, postoperative pain score, postoperative first passage of flatus, duration of hospital stay, total cost, number of lymph nodes retrieved, TNM classification, and postoperative complications. Follow-up data included follow-up time, use of chemotherapy, local recurrence rate, distant metastasis rate, and short-term survival rate.ResultsIn total, 150 patients (HAL-CME, 78; O-CME, 72) were included. The groups were similar in age, sex distribution, BMI, ASA classification, history of previous abdominal surgeries, tumor localization, and potential comorbidities. Patients in the HAL-CME group had shorter incision lengths, longer operative times, less operative blood loss, lower pain scores, earlier first passage of flatus, shorter hospital stay, higher total costs, similar numbers of lymph nodes retrieved, similar TNM classifications, and a comparable incidence of postoperative complications. The 2 groups were also similar in local recurrence rate, distant metastasis rate, and short-term survival rate.ConclusionThe results demonstrate that the HAL-CME procedure is a safe, valid, and feasible surgical method for right hemicolon cancers.

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Section: Discussionmentioning

confidence: 99%

Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches

et al. 2017

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“…The authors encouraged the use of MA for patients requiring a laparoscopic right hemicolectomy. Rotholtz et al [ 6 ] reported that the MA significantly reduced the operation time and time to intestinal recovery. Yan et al [ 11 ] published results showing that the MA resulted in a shorter operative time and less blood loss in laparoscopic right hemicolectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Our study revealed a significantly shorter operative time and less blood loss in the MA group. Possible reasons for this were as follows: a).with the MA, it was easy for the surgeon to keep the dissection at the bloodless plane between the mesocolon and the retroperitoneum and to reduce blood loss accordingly[ 6 ];b).less amount of bleeding was expected with MA during mobilization of the colon when ligating the vessels primarily[ 11 ]; c).in some rare conditions in which the colonic tumor coexists with a colonic inflammatory process (e.g., diverticulitis),the LA might be difficult and dangerous because the LA is blurred during the divisions[ 19 ]. Our results of operative time and blood loss are in agreement with reported operation times in published studies.…”

Section: Discussionmentioning

confidence: 99%

“…The traditional sequence used in open right hemicolectomy begins with lateral-to-medial approach (LA)[ 6 ]. With the uptake of minimal access techniques, many laparoscopic surgeons tried to use the medial-to-lateral approach (MA)[ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, some studies have compared the safety and efficacy of the MA and LA in laparoscopic colorectal surgery, revealing that the MA provides some potential short-term advantages [ 6 , 11 , 12 , 13 , 14 , 15 ].To our knowledge, no study has compared the MA and LA in open right hemicolectomy. Therefore, the objective of the present study was to evaluate the potential benefits of one of the approaches in a consecutive series of patients who underwent right open hemicolectomy.…”

Section: Introductionmentioning

confidence: 99%

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Open Right Hemicolectomy:Lateral to Medial or Medial to Lateral Approach?

Zhu

et al. 2015

PLoS ONE

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ObjectiveCurrently, no published studies have compared the clinical outcomes of the medial-to-lateral approach (MA) and lateral-to-medial approach (LA) for open right hemicolectomy. Thus, the present study aimed to assess whether one of these approaches has any potential benefits over the other.MethodsA retrospective study was performed of all patients who underwent open right hemicolectomy with pathologically confirmed disease who met the eligibility criteria between June 2008 and June 2012. The population was divided into an MA group and an LA group by propensity scoring. We compared patient demographic and clinical characteristic variables between the two groups and assessed short-term and long-term outcomes.ResultsA total of 450 patients (MA, n = 150; LA, n = 300) were evaluated. The operation time (MA,138.4 minutesvs.LA,166.2 minutes; P < .05) and blood loss (MA,52.0mL vs. LA,62.6mL; P < .05)were significantly lower in the MA group. No differences in the number of harvested lymph nodes and oncologic outcomes were observed between the two groups. Further subgroup analysis for stage III colon cancer revealed that the MA group had significantly more retrieved lymph nodes (MA,18.8vs. LA,16.0; P = .028). There were no differences in other variables between the two groups.ConclusionsThe MA reduced operative time and blood loss compared with the LA. We thus concluded that the MA provided short-term benefits compared with the LA in open right hemicolectomy for right-sided colon cancer.

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Current status and trend of laparoscopic right hemicolectomy for colon cancer

Matsuda

Yamashita

Hasegawa

et al. 2020

Annals of Gastroent Surgery

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Since the first report of laparoscopic surgery for colorectal cancer in 1991, 1 its popularity has been increasing worldwide based on evidence that laparoscopic surgery provides better short-term outcomes and similar oncological outcomes compared with open surgery, supported by previous large randomized clinical trials (RCTs). 2-5 Laparoscopic right hemicolectomy (LRH) is one of the most common procedures in colorectal cancer surgery, which is employed for right-sided colon cancer. However, it has several unique issues unlike other colorectal cancer surgeries. There were several different approaches for lymph node dissection (i.e. medial-to-lateral, lateral-to-medial, and cranial-to-caudal) and reconstruction (i.e. intracorporeal and extracorporeal). Furthermore, there are anatomical variations in vascular structures encountered during LRH, and various landmarks have been proposed for a successful surgery.

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Laparoscopic Colectomy

Abstract: The use of a medial approach in a laparoscopic colectomy provides short-term benefits compared with a lateral approach.

Cited by 32 publications

References 25 publications

Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches

Complete mesocolic excision in right hemicolectomy: comparison between hand-assisted laparoscopic and open approaches

Open Right Hemicolectomy:Lateral to Medial or Medial to Lateral Approach?

Current status and trend of laparoscopic right hemicolectomy for colon cancer

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