Laparoscopic complete mesocolic excision via combined medial and cranial approaches for transverse colon cancer

• Published in: Surgery today (Tokyo, Japan) Japan), 2017-05, Vol.47 (5), p.643-649
• Main Authors: Mori, Shinichiro, Kita, Yoshiaki, Baba, Kenji, Yanagi, Masayuki, Tanabe, Kan, Uchikado, Yasuto, Kurahara, Hiroshi, Arigami, Takaaki, Uenosono, Yoshikazu, Mataki, Yuko, Okumura, Hiroshi, Nakajo, Akihiro, Maemura, Kosei, Natsugoe, Shoji
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Colectomy - methods; Colon, Transverse - diagnostic imaging; Colon, Transverse - surgery; Colonic Neoplasms - diagnostic imaging; Colonic Neoplasms - pathology; Colonic Neoplasms - surgery; Feasibility Studies; Female; How to Do It; Humans; Imaging, Three-Dimensional - methods; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Mesocolon - surgery; Neoplasm Staging; Surgery; Surgery, Computer-Assisted - methods; Surgical Oncology; Treatment Outcome
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-016-1409-2

Purpose To evaluate the safety and feasibility of laparoscopic complete mesocolic excision via combined medial and cranial approaches with three-dimensional visualization around the gastrocolic trunk and middle colic vessels for transverse colon cancer. Methods We evaluated prospectively collected data of 30 consecutive patients who underwent laparoscopic complete mesocolic excision between January 2010 and December 2015, 6 of whom we excluded, leaving 24 for the analysis. We assessed the completeness of excision, operative data, pathological findings, length of large bowel resected, complications, length of hospital stay, and oncological outcomes. Results Complete mesocolic excision completeness was graded as the mesocolic and intramesocolic planes in 21 and 3 patients, respectively. Eleven, two, eight, and three patients had T1, T2, T3, and T4a tumors, respectively; none had lymph node metastases. A mean of 18.3 lymph nodes was retrieved, and a mean of 5.4 lymph nodes was retrieved around the origin of the MCV. The mean large bowel length was 21.9 cm, operative time 274 min, intraoperative blood loss 41 mL, and length of hospital stay 15 days. There were no intraoperative and two postoperative complications. Conclusion Our procedure for laparoscopic complete mesocolic excision via combined medial and cranial approaches is safe and feasible for transverse colon cancer.