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Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre.

ABSTRACT: AIM:To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision (CME) for colonic cancer over a 10-year period. METHODS:Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis (TNM) stages 0-III. RESULTS:The mean age of the patients was 71.9 years. The median length of stay was 5 d. The mean lymph node harvest was 17.8. The mortality rate was 1.2%. Fifteen patients were reoperated on for anastomotic leaks. The local recurrence rate was 2.3%. Five-year TTR and cancer-specific survival CSS were 83.1% and 90.3%. The location of the tumour was not a significant variable for survival in unadjusted and adjusted survival analysis. TNM stage and anastomotic leaks were significant variables with respect to survival. CONCLUSION:Laparoscopic CME results in acceptable complication rates and long-term oncologic results. It is important to avoid anastomotic leaks because of their negative effect on survival.

SUBMITTER: Storli KE

PROVIDER: S-EPMC5714803 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre.

Storli Kristian Eeg KE Lygre Kristin Bentung KB Iversen Knut Børge KB Decap Maria M Eide Geir Egil GE

World journal of gastrointestinal surgery 20171101 11

<h4>Aim</h4>To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision (CME) for colonic cancer over a 10-year period.<h4>Methods</h4>Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis (TNM) stages 0-III.<h4>Results</h4>The mean age of the patients was 71.9 years. The median length of stay was 5 d. ...[more]

PMID: 29225732

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Project description:ObjectiveDuring the past decade, the concept of complete mesocolic excision (CME) has been developed in an attempt to minimize recurrence for right-sided colon cancer. This study aims to compare outcomes of robotic versus laparoscopic right hemicolectomy with CME for right-sided colon cancer.MethodsWe performed a retrospective multicenter propensity score matching study. From July 2016 to July 2021, 382 consecutive patients from different Chinese surgical departments were available for inclusion out of an initial cohort of 412, who underwent robotic or laparoscopic right hemicolectomy with CME. Data of all patients were retrospectively collected and reviewed. Of these, 149 cases were performed by a robotic approach, while the other 233 cases were done by laparoscopy. Propensity score matching was applied at a ratio of 1:1 to compare perioperative, pathologic, and oncologic outcomes between the robotic and the laparoscopic groups (n = 142).ResultsBefore propensity score matching, there were no statistical differences regarding the sex, history of abdominal surgery, body mass index (BMI), American Joint Committee on Cancer (AJCC) staging system, tumor location, and center between groups (p > 0.05), while a significant difference was observed regarding age (p = 0.029). After matching, two comparable groups of 142 cases were obtained with equivalent patient characteristics (p > 0.05). Blood loss, time to oral intake, return of bowel function, length of stay, and complications were not different between groups (p > 0.05). The robotic group showed a significantly lower conversion rate (0% vs. 4.2%, p = 0.03), but a longer operative time (200.9 min vs. 182.3 min, p < 0.001) and a higher total hospital cost (85,016 RMB vs. 58,266 RMB, p < 0.001) compared with the laparoscopic group. The number of harvested lymph nodes was comparable (20.4 vs. 20.5, p = 0.861). Incidence of complications, mortality, and pathologic outcomes were similar between groups (p > 0.05). The 2-year disease-free survival rates were 84.9% and 87.1% (p = 0.679), and the overall survival rates between groups were 83.8% and 80.7% (p = 0.943).ConclusionDespite the limitations of a retrospective analysis, the outcomes of robotic right hemicolectomy with CME were comparable to the laparoscopic procedures with fewer conversions to open surgery. More clinical advantages of the robotic surgery system need to be further confirmed by well-conducted randomized clinical trials with large cohorts of patients.

Dataset Information

Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre.

Publications

Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre.

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