Short-term perioperative and oncological outcomes of complete versus conventional mesocolic excision in laparoscopic right hemicolectomy

Elgammal, Ahmed S.; Abobakr, Fawzy; Fayed, Asem

doi:10.4103/ejs.ejs_173_21

Short-term perioperative and oncological outcomes of complete versus conventional mesocolic excision in laparoscopic right hemicolectomy

Authors

Abstract

Introduction
Complete mesocolic excision (CME) has been proposed for colon cancer to improve both pathological and oncological outcomes. In this study, we compared the short-term and the relatively long-term (3 years) outcomes of CME with conventional excision in laparoscopic right hemicolectomy for right colon cancer.
Patients and methods
A total of 38 patients were recruited from the Department of General Surgery, Menoufia University Hospitals, who were had right-sided colon cancer and were treated by laparoscopic total mesocolic excision from December 2016 to December 2020. The perioperative and oncological outcomes in the CME group were compared with the conventional group, which included 38 patients who were previously treated in our unit.
Results
There was no significant difference between the CME and conventional groups regarding intraoperative blood loss, postoperative morbidity, or hospital stay. However, the CME group had more lymph nodes harvested (=0.004), longer duration of surgery (=0.001), and more R0 resection (=0.04) versus the conventional group. There was no difference in the 3-year overall survival rate between both the groups, but the 3-year disease-free survival was significantly better in the CME group (=0.03).
Conclusion
Laparoscopic CME is a safe, valid, and feasible surgical method for right-sided colon cancer. It is associated with comparable postoperative morbidity with the traditional method but has better pathological and short-term oncological outcomes.

Keywords