Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome.

Abstract:

BACKGROUND:To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS:600 consecutive patients were studied. RESULTS:Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 mm and mean lymph nodes harvested was 27 ± 3; mesocolic plane was achieved in 81% of cases. Survival was 83%; stratified survival in patients with stage II, IIIA/B and in the subgroup of stage IIIC patients with negative apical nodes was 88.7%, 72.4%, 71.4% respectively; stage IIIC patients with positive apical nodes showed poor survival (27.7%). Recurrence occurred in 177 patients (29.5%) and was mainly systemic (22.7%). At the multivariate analysis, "non mesocolic" plane of resection, positive N3 apical nodes and CEA levels >5 ng/dL were found to be independent prognostic factors. CONCLUSIONS:Laparoscopic right Mesocolectomy showed to be safe and yielded surgical specimens of high quality, with impact on survival; positive N3 apical nodes and "non mesocolic" planes were independently associated to poor outcome.

journal_name

Am J Surg

authors

Siani LM,Lucchi A,Berti P,Garulli G

doi

10.1016/j.amjsurg.2016.10.005

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

222-227

issue

2

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(16)30864-9

journal_volume

214

pub_type

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