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. 2021:92:365-371.

Totally laparoscopic right hemicolectomy with up-down approach. A single institution experience

Pasquale Cianci, Domenico Gattulli, Marina Minafra, Sabino Capuzzolo, Laura Cafagna, Valentina Ferraro, Rocco Tumolo, Enrico Restini
  • PMID: 34524113

Totally laparoscopic right hemicolectomy with up-down approach. A single institution experience

Pasquale Cianci et al. Ann Ital Chir. 2021.

Abstract
in English, Italian

Aim: Many laparoscopic techniques have been described for the treatment of right colon cancer. The purpose of this study is to communicate our experience in the totally laparoscopic treatment of right colon cancer and to report our short-term results in order to confirm the feasibility and safeness of this demanding procedure.

Material of study: From November 2017 to April 2020, we performed 384 surgical operations for colorectal cancers, of these 81 have involved tumors of the right colon in urgent and elective conditions. Right hemicolectomies with a totally laparoscopic approach were performed, by the same surgical team, in 55 patients in elective surgery.

Results: During the study period we evaluated intra and postoperative complications in terms of: demographic data and preoperative clinical characteristics, intraoperative and postoperative outcomes (operative time, blood loss, conversion rate, surgical complications, hospitalization, readmission, and mortality), pathological outcomes.

Discussion: Our experience confirms that totally laparoscopic approach, with up to down dissection, for the treatment of right colon cancer, performed by expert surgeons is a safe and feasible technique.

Conclusion: This procedure allows the mesocolon excision with outstanding number of harvested lymph nodes ensuring low complications and better oncological cleaning.

Key words: Central Vascular Ligation, Colorectal Cancer, Fluorescence GLaparoscopy, Right Hemicolectomy, Complete Mesocolic Excision, Surgery.

Molte tecniche laparoscopiche sono state descritte per il trattamento del cancro del colon destro. Lo scopo di questo studio è quello di comunicare la nostra esperienza nel trattamento totalmente laparoscopico del cancro del colon destro e di riportare i nostri risultati a breve termine al fine di confermare la fattibilità e la sicurezza di questa procedura impegnativa. Da novembre 2017 ad aprile 2020 abbiamo eseguito 384 interventi chirurgici per tumori del colon-retto, 81 di questi hanno coinvolto tumori del colon destro in condizioni di urgenza ed in elezione. In quest’ultimo scenario 55 sono state le emicolectomie destre con approccio totalmente laparoscopico eseguite, e tutte dallo stesso team chirurgico. Durante il periodo di studio abbiamo valutato le complicanze intra e postoperatorie in termini di: dati demografici e caratteristiche cliniche preoperatorie, esiti intraoperatori e postoperatori (tempo operatorio, perdita di sangue, tasso di conversione, complicanze chirurgiche, ospedalizzazione, riammissione e mortalità), esiti patologici. La nostra esperienza conferma che l’approccio totalmente laparoscopico, con dissezione dall’alto verso il basso, per il trattamento del cancro del colon destro, eseguito da chirurghi esperti è una tecnica sicura e fattibile. Questa procedura consente l’escissione del mesocolon con un numero elevato di linfonodi asportati, garantendo basse complicanze e un migliore risultato oncologico.

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