Clinical outcome of laparoscopic complete mesocolic excision in the treatment of right colon cancer

Abstract

Background

This study aimed to investigate the clinical outcome of complete mesocolic excision (CME) with a caudal-to-cranial medial approach in the treatment of right colon cancer.

Methods

The clinical data of 172 patients who underwent laparoscopic CME for right colon cancer and were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2010 to April 2015 were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) in relation to gender, age, history of abdominal surgery, tumor size, complications, and tumor–node–metastasis (TNM) classification were analyzed using the Kaplan–Meier survival curves.

Results

A total of 172 patients with 94 males and 78 females were included. The average surgical time was 113.5 ± 34.4 min, blood loss was 74.2 ± 28.1 mL, and the number of lymph nodes retrieved was 23.3 ± 9.2. No readmission or death occurred within 30 days after surgery. Postoperative complications occurred in 16.3% of the patients, which included wound infection (3 patients), chylous fistula (22 patients), anastomotic leakage (1 patient), anastomotic bleeding (1 patient), and lung infection (1 patient). The 3-year DFS and OS were 81.7 and 89.1%, respectively. The rate of DFS and OS was significantly higher in stages I and II compared with that in stage III (P < 0.05), and in stages IIIA and IIIB compared with that in stage IIIC (P < 0.05).

Conclusions

Laparoscopic CME with a caudal-to-cranial medial approach in the treatment of right colon cancer had good short-term efficacy and satisfactory oncological outcome.

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