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Feasibility and efficacy of laparoscopic radical right hemicolectomy with complete mesocolic excision using an 'artery-first' approach

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机构: [1]Department of Gastrointestinal (Tumor) Surgery, Guangdong Province Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu, Guangzhou, Guangdong 86/510120, China
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关键词: Laparoscopic right hemicolectomy complete mesocolic excision 'artery-first' approach

摘要:
Background: According to previous guidelines, the lymph nodes around the right side of the superior mesenteric artery (SMA) should be dissected and removed en bloc. However, due to the technical challenge and the risk of complications, most surgeons perform the dissection along the axis of the superior mesenteric vein (SMV). Herein, we described an 'artery-first' approach for laparoscopic radical extended right hemicolectomy with complete mesocolic excision (CME). Methods: A total of 22 cases were collected from January to October 2016. The right side of the SMA and SMV were exposed and separated, and the No. 203, No. 213 and No. 223 lymph nodes were dissected en bloc. Toldt's fascia was dissected and expanded laterally to the ascending colon, cranial to the pancreas head. The caudal root of the mesentery and lateral attachments of the ascending colon were completely mobilized. Results: There were 9 male and 13 female patients, with a mean age of 63.1 (range, 39-83) years and the mean body mass index was 24.6 (range, 18.3-37.7) kg/m(2). The mean operative time was 192.5 (range, 145-240) minutes and the mean intra-operative blood loss was 55.0 (range, 10-300) ml. The mean number of harvested lymph nodes was 27.0 (range, 13-55) and the time to flatus and hospital stay were 35.0 (range, 26-120) hours and 7.5 (range, 5-20) days, respectively. Minor complications occurred in two patients and no post-operative death was observed. Conclusions: The preliminary results suggest that the reported approach may be a feasible and safe procedure that is more in accordance with the principles of CME.

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出版当年[2018]版:
大类 | 3 区 医学
小类 | 4 区 胃肠肝病学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 胃肠肝病学
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出版当年[2017]版:
Q3 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q2 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Department of Gastrointestinal (Tumor) Surgery, Guangdong Province Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu, Guangzhou, Guangdong 86/510120, China
通讯作者:
通讯机构: [1]Department of Gastrointestinal (Tumor) Surgery, Guangdong Province Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Yuexiu, Guangzhou, Guangdong 86/510120, China [*1]Department of Gastrointestinal (Tumor) Surgery, Guangdong Province Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu, Guangzhou, Guangdong 86/510120, China.
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