Inferior versus medial approach in laparoscopic and robotic surgery with complete mesocolic excision for right-sided colon cancer: propensity score-matched analysis.
S Izukawa, M Numata, T Harada, Y Atsumi, K Kazama, S Sawazaki, T Godai, H Mushiake, A Higuchi, H Tamagawa, Y Suwa, J Watanabe, T Sato, A Saito
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引用次数: 0
Abstract
Background: Right-sided colon cancer surgery is a highly difficult operation, and ensuring perioperative safety is an important issue. While various approaches have been proposed for right-sided colon cancer, there are few reports comparing them. The present study compared the inferior approach (IA) and medial approach (MA) for right-sided colon cancer surgery and evaluated their safety.
Methods: We compared 528 cases of right-sided colon cancer surgery performed at our five affiliated institutions from 2017 to 2023, divided into IA and MA groups of 122 cases each using propensity score matching. Short-term outcomes of both groups were retrospectively evaluated, focusing on perioperative complications and perioperative mortality as the primary outcomes.
Results: After propensity score matching, all baseline variables were well balanced. All patients underwent complete mesocolic excision. No statistically significant difference (p < 0.05) was observed between the two groups in the incidence of postoperative complications, and no cases of severe complications were observed in either group. The incidence rates of Clavien-Dindo grade ≥ 3 complications (IA/ MA): anastomotic leakage (0%/ 0.8%); intraabdominal abscess (0.8%/ 1.6%); surgical site infection (0.8%/ 3.2%); ileus (0%/ 0.8%); and anastomotic bleeding: (0%/ 0%). Postoperative hospital stay was significantly shorter in the IA group. Although there was a significant difference in the number of dissected lymph nodes, both groups had good R0 resection rates.
Conclusions: Both IA and MA represent safe and feasible approaches for right-sided colon cancer and can be selected on the basis of the surgeon's preference.
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.
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