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ANZ journal of surgery · Oct 2018
Oncological outcomes of complete versus conventional mesocolic excision in laparoscopic right hemicolectomy.
- Min Sung An, HyungJoo Baik, Se Hui Oh, Yo-Han Park, Sang Hyuk Seo, Kwang Hee Kim, Kwan Hee Hong, and Ki Beom Bae.
- Department of Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
- ANZ J Surg. 2018 Oct 1; 88 (10): E698-E702.
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.© 2018 Royal Australasian College of Surgeons.
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