D3 Extended Mesenterectomy in Right Colectomy for Cancer: A Cadaver Simulation Model.

Autor:	You K; Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York., Gachabayov M; Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York., Nesgaard JM; Toensberg Hospital, University of Oslo, Norwa., Bandovic J; Department of Pathology, State University of New York, Stony Brook, New York., Ignjatovic D; Akershus Hospital, University of Oslo, Norway., Bakka A; Akershus Hospital, University of Oslo, Norway., Bergamaschi R; Division of Colon and Rectal Surgery, State University of New York, Stony Brook, New York.
Jazyk:	angličtina
Zdroj:	Surgical technology international [Surg Technol Int] 2018 Jun 01; Vol. 32, pp. 109-113.
Abstrakt:	Background: D3 extended mesenterectomy (D3EM) for right colon cancer has received increased attention owing to suggested improvement of oncological outcomes. The aim of this study was to evaluate the proficiency-based progression of content-valid metrics in a cadaveric model for right colectomy with D3EM. Materials and Methods: Three expert surgeons were enrolled. Surgeon one performed the procedure robotically and surgeons two and three performed open D3EM. Proficiency-based progression was recorded for eight content-valid outcomes. The superior mesenteric vein (SMV) and artery were cannulated by independent observers to evaluate vascular tears. The specimens were analyzed for lymph node harvest by a pathologist blinded to surgical access and to the surgeon. Results: Operating times did not differ among surgeons (50.2, 32.4 and 43.7 min). SMV tears occurred in procedures A and B only. There was no significant progression in lymph node harvest for D2 (p=0.913) and D3EM (p=0.264). Conclusions: Cadaveric training in D3EM was associated with progression in avoidance of vascular tears with no significant changes in operating time and lymph node harvest.
Databáze:	MEDLINE
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