Proposal for standardization of laparoscopic D3 lymphadenectomy for right colon cancer.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2024-08-20 DOI:10.1007/s10151-024-02974-8

Á Garcia-Granero, A Gil-Catalán, S Jerí-McFarlane, J Sancho-Muriel, G Pellino, M Gamundí-Cuesta, E Garcia-Granero, F X Gonzalez-Argenté

{"title":"Proposal for standardization of laparoscopic D3 lymphadenectomy for right colon cancer.","authors":"Á Garcia-Granero, A Gil-Catalán, S Jerí-McFarlane, J Sancho-Muriel, G Pellino, M Gamundí-Cuesta, E Garcia-Granero, F X Gonzalez-Argenté","doi":"10.1007/s10151-024-02974-8","DOIUrl":null,"url":null,"abstract":"Background: This study presents a laparoscopic surgical protocol for right hemicolectomy and D3 lymphadenectomy (R-D3L) in right colon cancer and reports the oncological outcomes based on a prospective series.Methods: The study comprises two phases. In the first phase, a dynamic demonstration of the R-D3L surgical protocol is provided through textual explanation, illustrations, and edited surgical videos. The protocol emphasizes technical steps such as dissection of the embryological plane of the right mesocolon, high tie of ileocolic vessels, surgical trunk of Gillot dissection, and high tie of superior right colic vein (SRCV). In the second phase, a prospective observational study was conducted involving patients undergoing R-D3L surgery with this protocol between July 2015 and July 2021. Demographic, perioperative, and postoperative variables are analyzed, along with anatomopathological variables and oncological outcomes.Results: A total of 33 patients were analyzed. Median operative time was 202 min. Perioperative bleeding occurred in 6%. Postoperative complications were mild (Clavien-Dindo III in 2%). Postoperative ileus was observed in 15%. No anastomotic dehiscence was reported. The median postoperative stay was 7 days. The median number of resected lymph nodes was 26, with 27% having positive nodes and 70% were classified as stage T3 or T4. After a median follow-up of 45 months, local recurrence, distant recurrence, and carcinomatosis rates were 0%. Mortality rate from other causes was 9%.Conclusion: The surgical protocol shown in the present study could help in the implementation of this technique in those units that consider it appropriate.","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"28 1","pages":"111"},"PeriodicalIF":2.7000,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-024-02974-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: This study presents a laparoscopic surgical protocol for right hemicolectomy and D3 lymphadenectomy (R-D3L) in right colon cancer and reports the oncological outcomes based on a prospective series.

Methods: The study comprises two phases. In the first phase, a dynamic demonstration of the R-D3L surgical protocol is provided through textual explanation, illustrations, and edited surgical videos. The protocol emphasizes technical steps such as dissection of the embryological plane of the right mesocolon, high tie of ileocolic vessels, surgical trunk of Gillot dissection, and high tie of superior right colic vein (SRCV). In the second phase, a prospective observational study was conducted involving patients undergoing R-D3L surgery with this protocol between July 2015 and July 2021. Demographic, perioperative, and postoperative variables are analyzed, along with anatomopathological variables and oncological outcomes.

Results: A total of 33 patients were analyzed. Median operative time was 202 min. Perioperative bleeding occurred in 6%. Postoperative complications were mild (Clavien-Dindo III in 2%). Postoperative ileus was observed in 15%. No anastomotic dehiscence was reported. The median postoperative stay was 7 days. The median number of resected lymph nodes was 26, with 27% having positive nodes and 70% were classified as stage T3 or T4. After a median follow-up of 45 months, local recurrence, distant recurrence, and carcinomatosis rates were 0%. Mortality rate from other causes was 9%.

Conclusion: The surgical protocol shown in the present study could help in the implementation of this technique in those units that consider it appropriate.

Abstract Image

查看原文本刊更多论文

关于腹腔镜右侧结肠癌 D3 淋巴腺切除术标准化的建议。

背景：本研究介绍了右半结肠癌右半结肠切除术和 D3 淋巴腺切除术（R-D3L）的腹腔镜手术方案，并报告了基于前瞻性系列研究的肿瘤学结果：研究分为两个阶段。第一阶段，通过文字解释、插图和编辑的手术视频，动态演示 R-D3L 手术方案。该方案强调的技术步骤包括右系膜胚胎平面解剖、回肠结肠血管高位结扎、Gillot手术干解剖和右结肠上静脉（SRCV）高位结扎。第二阶段是一项前瞻性观察研究，研究对象是在 2015 年 7 月至 2021 年 7 月期间接受该方案 R-D3L 手术的患者。研究分析了人口统计学、围手术期和术后变量，以及解剖病理学变量和肿瘤学结果：结果：共对33名患者进行了分析。中位手术时间为 202 分钟。围手术期出血发生率为 6%。术后并发症较轻（2%为Clavien-Dindo III）。15%的患者出现术后回肠梗阻。没有吻合口裂开的报道。术后中位住院时间为 7 天。切除淋巴结的中位数为 26 个，其中 27% 的淋巴结为阳性，70% 的淋巴结被归类为 T3 或 T4 期。中位随访45个月后，局部复发率、远处复发率和癌变率均为0%。其他原因导致的死亡率为9%：本研究中展示的手术方案有助于那些认为合适的单位实施这项技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.