Short-term results of laparoscopic and open complete mesocolic excision with D3 lymph node dissection for left-sided colon cancer
https://doi.org/10.22416/1382-4376-2016-26-1-99-106
Abstract
Aim of investigation. To estimate possible advantages and shortcomings of laparoscopic complete mesocolic excision with D3 lymph node dissection in the treatment of left-sided colon cancer in comparison to open approach according to analysis of short-term outcomes. Material and methods. Investigation was designed as retrospective-prospective case-control study (with analog group comparison). Patients with left-sided colon cancer of stages II-III were selected from prospectively collected database. Groups have been generated according to case-control principle: the I group included patients who underwent open complete mesocolic excision with D3 lymph node dissection, the II group comprised patients who underwent laparoscopic intervention in the same volume. Results. Each group included 54 patients. Duration of operation and volume of intraoperative blood loss in the II group patients was less, than in the I group. Postoperative morbidity rate had no statistically significant differences in both groups. Rehabilitation in early postoperative period was faster in the II group vs I group. Conclusion. Laparoscopic complete mesocolic excision with D3 lymph node dissection is safe type of surgery, which allows to improve short-term results of surgical treatment of patients with stage II-III left-sided colon cancer. Morphological scores indicate identical efficacy in achievement of radical treatment for laparoscopic and open techniques from the standpoint of modern oncology principles. However, correct estimation of long-term outcomes require further studies.
About the Authors
P. V. Tsarkov
State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of healthcare of the Russian Federation, Moscow, the Russian Federation. Chair of colorectal and endoscopic surgery
Russian Federation
Russian Federation
I. A. Tulina
State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of healthcare of the Russian Federation, Moscow, the Russian Federation. Chair of colorectal and endoscopic surgery
Russian Federation
Russian Federation
A. Yu. Kravchenko
State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of healthcare of the Russian Federation, Moscow, the Russian Federation. Chair of colorectal and endoscopic surgery
Russian Federation
Russian Federation
A. V. Leont’Yev
State educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of healthcare of the Russian Federation, Moscow, the Russian Federation. Chair of colorectal and endoscopic surgery
Russian Federation
Russian Federation
References
1. Апрощенко А.О. Основные этапы развития лапароскопической хирургии в онкологической колопроктологии. Вестник РОНЦ им. Н.Н. Блохина РАМН 2012; 23(1):3-8.
2. Борота А.В., Совпель О.В., Мирошниченко Е.Ю. Начальный опыт лапароскопических вмешательств при раке толстой кишки: уроки, извлеченные в период освоения. Вестник неотложной и восстановительной медицины 2014; 15(2):180-4.
3. Ефетов С.К. Мезоколонэктомия и D3 лимфодиссекция в лечении рака правой половины ободочной кишки: Автореф. дис. … канд. мед. наук. М., 2014. 27 с.
4. Йулдашев А.Г. Расширенная лимфаденэктомия в лечении рака левых отделов ободочной кишки: Автореф. дис. … канд. мед. наук. М., 2012. 26 с.
5. Карачун А.М., и др. Место лапароскопических операций при раке ободочной и прямой кишок. Практическая онкология 2012; 13(4):261-8.
6. Карсанов А.М., Маскин С.С., Лопастейский Д.С. Возможности оптимизации хирургического лечения рака ободочной кишки. Кубанский науч мед вестник 2013; 7:92-6.
7. Кит О.И., и др. Современный подход к оперативному лечению рака ободочной и прямой кишки. Новочеркасск, 2014. 142 с.
8. Пучков К.В., Хубезов Д.А. Малоинвазивная хирургия толстой кишки: Руководство для врачей. М.: Медицина, 2005. 280 с.
9. Симонов Н.Н., и др. Современные принципы хирургического лечения рака ободочной кишки. Практическая онкология 2000; 1:14-8.
10. Хатьков И.Е., и др. История развития лапароскопической хирургии. Онкол колопроктол 2012; 2:35-9.
11. Царьков П.В., и др. Скелетизация нижней брыжеечной артерии с парааортальной лимфаденэктомией в лечении рака левой половины ободочной кишки. Новости колопроктол 2012; 2:60-70.
12. Царьков П.В., и др. Парааортальная лимфаденэктомия со скелетизацией нижней брыжеечной артерии в лечении рака сигмовидной кишки. Хирургия 2012; 7:41-8.
13. Baek J.H., Lee G.J., Lee W.S. Comparison of long-term oncologic outcomes of stage III colorectal cancer following laparoscopic versus open surgery. Ann Surg Treat Res 2015; 88(1):8-14.
14. Bertelsen C.A., et al. Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study. Lancet Oncol 2014; 12.
15. Chow C.F., Kim S.H. Laparoscopic complete mesocolic excision: West meets East. World J Gastroenterol 2014; 21(20):14301-7.
16. Chun К.Н., et al. Comparison of compliance of adjuvant chemotherapy between laparoscopic and open surgery in patients with colon cancer. Ann Coloproctol 2014; 30(6):274-9.
17. Desiderio J., Trastulli S., Ricci F., Penzo J., Cirocchi R. Laparoscopic versus open left colectomy in patients with sigmoid colon cancer: prospective cohort study with longterm follow-up. Int J Surg 2014; 12(8):745-50.
18. Fujii S., et al. Short-term results of a randomized study between laparoscopic and open surgery in elderly colorectal cancer patients. Surg Endosc 2014; 28:466-76.
19. Gouvas N., et al. Complete mesocolic excision in colon cancer surgery: a comparison between open and laparoscopic approach. The Association Coloproctol Great Britain Ireland 2012; 14:1357-64.
20. Hasegawa H., et al. What is the effect of laparoscopic colectomy on pattern of colon cancer recurrence? A propensity score and competing risk analysis compared with open colectomy. Ann Surg Oncol 2014; 21(8):2627-35.
21. Hohenberger W., Weber K., Matzel K., Papadopoulos T., Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis 2009; 4(11):354-64.
22. Hu J., Li Y., Xiang M., Zhao R. Clinical study of reduced-port laparoscopy-assisted resection for cancer at the sigmoid colon and upper rectum. Zhonghua Wei Chang Wai Ke Za Zhi 2014; 17(12):1212-5.
23. Kil-Su Han, Gyu-Seog Choi, Jun-Seok Park. Shortterm outcomes of a laparoscopic left hemicolectomy for descending colon cancer: Retrospective comparison with an open left hemicolectomy. J Korean Soc Coloproctol 2010; 26(5):347-53.
24. Liang J. Primacy of surgery for colorectal cancer outcomes. BJS 2015; 1:45-8.
25. Liang J.T., Lai H.S., Huang J. Long-term oncologic results of laparoscopic D3 lymphadenectomy with complete mesocolic excision for right-sided colon cancer with clinically positive lymph nodes. Surg Endosc 2015; 29(8):2394-401.
26. Musselman R.P., et al. Laparoscopic colorectal surgery in the emergency setting: Trends in the province of Ontario. Surg Laparosc Endosc Percutan Tech 2015; 19:45-9.
27. Nakajima K., et al. Quality control by photo documentation for evaluation of laparoscopic and open colectomy with D3 resection for stage II/III colorectal cancer: Japan Clinical Oncology Group Study JCOG 0404. Jpn J Clin Oncol 2014; 44(9):799-806.
28. Shin J.W., Amar A.H., Kim S.H., Kwak J.M., Baek S.J. Complete mesocolic excision with D3 lymph node dissection in laparoscopic colectomy for stages II and III colon cancer: long-term oncologic outcomes in 168 patients. Tech Coloproctol 2014; 18(9):795-803.
29. Veldkamp R., Kuhry E., Hop W.C., Jeekel J., Kazemier G., Bonjer H.J., Haglind E., Pаhlman L., Cuesta M.A., Msika S., Morino M., Lacy A.M. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of arandomised trial. Lancet Oncol 2005; 6(7):477-84.
30. West N.P., Hohenberger W., Weber K., Perrakis A., Finan P.J., Quirke P. Complete mesocolic excision with central vascular ligation produces an oncologicallysuperior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol 2010; 28(2):272-8.
31. West N.P., Morris E.J., Rotimi O., Cairns A., Finan P.J., Quirke P. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol 2008; 9(9):857-65.
32. Zheng Z., et al. Comparative effectiveness of laparoscopy vs open colectomy among nonmetastatic colon cancer patients: an analysis using the National Cancer Data Base. J Natl Cancer Inst 2015; 6(107):3-5.
Review
For citations:
Tsarkov P.V., Tulina I.A., Kravchenko A.Yu., Leont’Yev A.V. Short-term results of laparoscopic and open complete mesocolic excision with D3 lymph node dissection for left-sided colon cancer. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016;26(1):99-106. (In Russ.) https://doi.org/10.22416/1382-4376-2016-26-1-99-106
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