Laparoscopic colectomy for transverse colon carcinoma

Abstract

The results of laparoscopic colon resection for transverse colon carcinoma are comparable to the results of laparoscopic resection of right or sigmoid colon cancer and open resection of transverse colon carcinoma. These results suggest that laparoscopic resection of transverse colon carcinoma is safe and feasible.

Curative Resection of Transverse Colon Cancer via Minilaparotomy

“…Our results contrasted with those reported by some laparoscopic experts. [20][21][22] Laparoscopically assisted resection of transverse colon cancer was reported to take significantly longer in terms of operative time than laparoscopically assisted resection of cancer at other sites 20,21 or conventional open surgery 22 for transverse colon cancer; although reports 23,24 from Korea show that no significant difference was found in such comparisons. In addition, 2 study groups 20,21 suggested that laparoscopically assisted resection of transverse colon cancer may have an insignificant higher rate of postoperative complications, which should not be ignored and may be a reflection of the greater complexity associated with the resection of transverse colon, compared with other less challenging segmental colectomies.…”

“…[20][21][22] Laparoscopically assisted resection of transverse colon cancer was reported to take significantly longer in terms of operative time than laparoscopically assisted resection of cancer at other sites 20,21 or conventional open surgery 22 for transverse colon cancer; although reports 23,24 from Korea show that no significant difference was found in such comparisons. In addition, 2 study groups 20,21 suggested that laparoscopically assisted resection of transverse colon cancer may have an insignificant higher rate of postoperative complications, which should not be ignored and may be a reflection of the greater complexity associated with the resection of transverse colon, compared with other less challenging segmental colectomies. When our minilaparotomy series is compared with recently reported series of laparoscopically assisted resection in terms of operative time, blood loss, and postoperative complications, the mean operative time (133.5 minutes) is markedly shorter in our minilaparotomy series than those (203.6-260 minutes) [20][21][22][23][24] of reported laparoscopically assisted series, and the blood loss and the incidence of postoperative complications seem to be compatible to or smaller than those of laparoscopically assisted series.…”

“…In addition, 2 study groups 20,21 suggested that laparoscopically assisted resection of transverse colon cancer may have an insignificant higher rate of postoperative complications, which should not be ignored and may be a reflection of the greater complexity associated with the resection of transverse colon, compared with other less challenging segmental colectomies. When our minilaparotomy series is compared with recently reported series of laparoscopically assisted resection in terms of operative time, blood loss, and postoperative complications, the mean operative time (133.5 minutes) is markedly shorter in our minilaparotomy series than those (203.6-260 minutes) [20][21][22][23][24] of reported laparoscopically assisted series, and the blood loss and the incidence of postoperative complications seem to be compatible to or smaller than those of laparoscopically assisted series. On the basis of our results, we feel that lymph node dissection around the middle colic vessels via the minilaparotomy approach is not difficult compared with conventional open surgery, although there is a knack to exposing the superior mesenteric vessels via minilaparotomy, as described in our surgical procedures.…”

A New Approach to Laparoscopic Lymph Node Excision in Cases of Transverse Colon Cancer

“…A recent study [10,11,12,13] on the outcome of laparoscopic surgery for transverse colon cancer by Akiyoshi et al [10] revealed that laparoscopic resection for transverse colon cancer can be performed safely, with similar short-term postoperative outcomes to those for colon cancer at other sites. In these reports, the authors did not adopt the method described by us; nevertheless, they show the validity of employing laparoscopic surgery for transverse colon cancer, based on the short-term outcomes.…”

“…The main reason for excluding these patients was the view that it would be difficult to perform LAC for transverse colon cancer. There have been recent reports on the safety and efficacy of LAC even for cases of transverse colon cancer [10,11,12,13]; however, for safe laparoscopic resection of transverse colon cancer, more complex operative manipulations and superior skills are necessary as compared to those needed for ordinary laparoscopic resection of the large bowel. In this paper, we present a new approach used at our facility for lymph node excision during LAC for transverse colon cancer.…”