Laparoscopic complete mesocolic excision for right colon cancer

Surgical Endoscopy, 05/11/2012

The embedded didactic video demonstrates a straight laparoscopic complete mesocolic excision with high–vessel ligation for a patient who had a right colon cancer. Laparoscopic right complete mesocolic excision is a safe and effective procedure associated with excellent 3–year oncologic outcomes and accelerated postoperative recovery.

Methods

  • A prospective series of 52 consecutive patients with right colon cancer underwent laparoscopic complete mesocolic excision with high–vessel ligation.
  • Four of the patients required laparoscopic en bloc extended resections for local invasion.
  • The median operative time was 136 min (interquartile range [IQR], 105–167 min), and the median blood loss was 20 ml (IQR, 10–45 ml).
  • The median hospital stay was 3 days (IQR, 3–5 days).
  • All the patients had an R0 oncologic resection with median margins of 12 cm, and a median of 22 lymph nodes (IQR, 18–29 lymph nodes) was retrieved.
  • The median follow–up period was 38 months (IQR, 23–54 months).

Results

  • Of 14 patients with tumor–positive lymph nodes, 2 experienced distant recurrence.
  • There were no local recurrences, but four patients experienced metastatic disease at a median of 37 months (IQR, 22–46 months).
  • The median overall survival time was 38 months (IQR, 23–54 months).

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