Oncologic safety of transverse colon cancer surgery without central vessel ligation of middle colic artery.

Autor: Yang IJ; Department of Colorectal Surgery, Chungnam National University Hospital and College of Medicine, 282 Munwharo Junggu, Daejeon, 35015, Republic of Korea., Yoon SH; Department of Colorectal Surgery, Chungnam National University Hospital and College of Medicine, 282 Munwharo Junggu, Daejeon, 35015, Republic of Korea., Kim JY; Department of Colorectal Surgery, Chungnam National University Hospital and College of Medicine, 282 Munwharo Junggu, Daejeon, 35015, Republic of Korea., Lee KH; Department of Colorectal Surgery, Chungnam National University Hospital and College of Medicine, 282 Munwharo Junggu, Daejeon, 35015, Republic of Korea. Kaylee0410@gmail.com.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Oct; Vol. 38 (10), pp. 6037-6045. Date of Electronic Publication: 2024 Aug 12.
DOI: 10.1007/s00464-024-11159-1
Abstrakt: Background: Surgical standardization for transverse colon cancers (TCC) has not been established, and the oncologic benefit of central vessel ligation (CVL) are still unclear. This study aimed to evaluate the oncologic safety of TCC surgery without CVL of the middle colic artery (MCA).
Methods: This is a single-center, retrospective, observational, comparative study. The clinical, surgical, and pathological characteristics of the patients who underwent radical surgery for non-metastatic TCC between January 2012 and December 2020 were investigated, and the characteristic and oncologic outcomes of No CVL and CVL groups were compared.
Results: The number of No CVL and CVL groups was 47 (44.3%) and 59 (55.7%), respectively. There was no statistically significant difference between the two groups in surgical complications, stage, mean number of retrieved lymph nodes (LN) (24.12 vs. 22.36 p = 0.464), mean number of metastatic LN (1.53 vs. 0.74, p = 0.163), mean proximal margin (19.2 cm vs. 16.7 cm, p = 0.139), mean distal margin (9.6 cm vs. 9.9 cm, p = 0.753), adjuvant chemotherapy, total recurrence rate (6.4 vs. 11.9%, p = 0.507), lymphatic recurrence rate (0.0% vs. 5.1%, p = 0.253), and local recurrence rate (2.1 vs. 1.7%, p = 0.984). Furthermore, there was no statistically significant difference of 5-year disease-free survival (DFS) and overall survival (OS) in stage II (DFS: 94.4 vs. 91.3%, p = 0.685, OS: 94.1 vs. 95.5%, p = 0.838) and stage III (DFS: 88.5 vs. 68.4%, p = 0.253, OS: 100.0% vs. 79.7, p = 0.328).
Conclusion: TCC surgery without CVL of the MCA showed comparable surgical and oncologic outcomes compared to surgery with CVL. Therefore, preservation of a branch of the MCA may be considered a safe option, when combined with adequate lymph node dissection, if necessary. A large, prospective, and controlled study will be necessary to provide solid evidence of the oncologic safety of this procedure.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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