Oncological outcomes of complete versus conventional mesocolic excision in laparoscopic right hemicolectomy

• DOI: 10.1111/ans.14493
• Publication Date: 2018-06-12T23:32:00Z
• Authors: Min Sung An; HyungJoo Baik; Se Hui Oh; Yo‐Han Park; Sang Hyuk Seo; Kwang Hee Kim; Kwan Hee Hong; Ki Beom Bae
• Keywords: Adult; Male; 2. Zero hunger; China; Operative Time; Kaplan-Meier Estimate; Length of Stay; Middle Aged; Disease-Free Survival; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Case-Control Studies; Colonic Neoplasms; Humans; Female; Laparoscopy; Neoplasm Invasiveness; Hospital Mortality; Patient Safety; Colectomy; Aged; Mesocolon; Neoplasm Staging

BackgroundComplete mesocolic excision (CME) has been proposed for colon cancer to improve oncological outcomes. The risks and benefits of laparoscopic CME have not been examined fully. We compared short‐ and long‐term outcomes of CME with a conventional mesocolic excision (non‐CME) in laparoscopic right hemicolectomy (RHC) for right‐sided colon cancer.MethodsIn total, 115 patients who underwent laparoscopic RHC with stage I–III right‐sided colon cancer at Busan Paik Hospital from August 2007 to October 2011 were enrolled in this case–control study. Three trained colorectal surgeons reviewed videos of the surgeries; patients were divided into two groups: those who underwent a CME (CME group, n = 34) and those who underwent a conventional mesocolic excision (non‐CME group, n = 81).ResultsThere was no significant difference between the CME and non‐CME groups in operative time, post‐operative complications, or hospital stay. However, the CME group had more lymph nodes harvested (P < 0.001) and lower blood loss (P = 0.016) versus the non‐CME group. There was no difference in 5‐year disease‐free survival rate between the groups, but 5‐year overall survival rate was 100% in the CME group and 89.49% in the non‐CME group (P < 0.05).ConclusionsLaparoscopic RHC with CME is safe and associated with better 5‐year overall survival rate than non‐CME for patients with stage I–III right‐sided colon cancer. Implementation of CME surgery might improve oncological outcomes for patients with right‐sided colon cancer.