Surgical Outcomes of Laparoscopic Right Colectomy with Complete Mesocolic Excision

• Published in: Journal of the Society of Laparoendoscopic Surgeons Vol. 24; no. 2; p. e2020.00023
• Main Authors: Olmi, Stefano, Oldani, Alberto, Cesana, Giovanni, Ciccarese, Francesca, Uccelli, Matteo, Giorgi, Riccardo, Villa, Roberta, Maria De Carli, Stefano
• Format: Journal Article
• Language: English
• Published: United States Society of Laparoendoscopic Surgeons 01.04.2020
• Subjects: Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Colectomy - methods; Colonic Neoplasms - surgery; Female; Humans; Laparoscopy - methods; Length of Stay; Male; Mesocolon - surgery; Middle Aged; Minimally Invasive Surgical Procedures; Operative Time; Peritoneal Neoplasms - surgery; Postoperative Complications - etiology; Retrospective Studies; Robotic Surgical Procedures - methods; Treatment Outcome; Laparoscopy; Central Vascular Ligation; Laparoscopic right colectomy; Colorectal cancer; Complete Mesocolic Excision
• ISSN: 1086-8089; 1938-3797
• DOI: 10.4293/JSLS.2020.00023

Literature demonstrates that colorectal cancer is nowadays one of the most common malignancies. Laparoscopy and robotic surgery are progressively gaining popularity in the treatment of colorectal tumors. Complete mesocolic excision and central vascular ligation have been widely adopted with encouraging results in terms of an improvement of overall survival, but some studies in the literature seem to demonstrate a higher morbidity rate. We conducted a retrospective study from 01/01/2010 to 30/04/2019 on a series of 250 patients, 155 males (62%) and 95 females (38%) who underwent right colectomy with minimally invasive approach, complete mesocolic excision, central vascular ligation, and intracorporeal anastomosis. No perioperative mortality occurred. Postoperative morbidity rate was 6%, including 10 cases of anastomotic leak (5%). Conversion rate was 2.5%. Mean hospital stay was 6 days (range, 4-25 days). Mean operative time was 70 minutes (range, 50-130 minutes). No cases of duodenal or pancreatic damages, no chronic pain or diarrhea, and no severe alteration of bowel function were recorded. We observed only 3 cases of transient delayed gastric emptying. Laparoscopic right colectomy with complete mesocolic excision, central vascular ligation and intracorporeal anastomosis leads to encouraging oncological mid- and long-term outcomes with low complications rates.