Surgeons' practices and preferences for performing right hemicolectomy for colorectal cancer: results from the SuPrHem survey

Abstract

Surgical techniques for right hemicolectomy (RHC) show considerable heterogeneity. To identify potential areas for improvement and standardization, the objective of this survey was to evaluate and report current practices and preferences among surgeons for performing RHC for colorectal cancer. An international online survey consisting of 31 questions was distributed to general surgeons worldwide to assess their preferred techniques for performing RHC. A total of 368 surgeons from 48 countries responded. Among them, 47% reported performing at least 90% of RHC laparoscopically, while 40% used a robotic approach. The most common dissection technique was a medial-to-lateral vessel-first approach, used by 82.3% of respondents. During laparoscopic procedures, 51.6% of surgeons performed extracorporeal anastomosis, whereas 82.9% of those using a robotic approach favored intracorporeal anastomosis. Fluorescence angiography was routinely used by 39.9% of respondents. The Pfannenstiel incision was the most frequently selected extraction site (46.5%) especially if intracorporeal anastomosis was performed (81.8%). The preferred technique for performing RHC includes a laparoscopic approach with intracorporeal lymph node dissection and extracorporeal anastomosis. Most RHC procedures therefore remain laparoscopy-assisted rather than fully minimally invasive. Robotic surgery appears to facilitate a fully minimally invasive approach including intracorporeal anastomosis.

Keywords: Colorectal cancer; Laparoscopy; MIS; Minimally invasive surgery; Robotic.