Robotic complete mesocolic excision with central vascular ligation for right colonic tumours – a propensity score-matching study comparing with standard laparoscopy
| Autor: | Nicholas P. West, Manfred Odermatt, Ngianga Ii Kandala, Nasir Z. Ahmad, Jim Khan, David Jayne, A. Ahmad |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty AcademicSubjects/MED00910 Colorectal cancer Operative Time education Superior mesenteric vessels 03 medical and health sciences Postoperative Complications 0302 clinical medicine Robotic Surgical Procedures medicine Humans Ascending colon Propensity Score Laparoscopy Ligation Lymph node Colectomy Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry General Medicine Length of Stay Middle Aged medicine.disease Survival Analysis Surgery Dissection medicine.anatomical_structure 030220 oncology & carcinogenesis Colonic Neoplasms Right Colectomy Propensity score matching Lymph Node Excision Female Original Article 030211 gastroenterology & hepatology Lymph Nodes AcademicSubjects/MED00010 business Mesocolon |
| Zdroj: | Khan, J, Ahmad, A, Odermatt, M, Jayne, D G, Ahmad, N Z, Kandala, N I & West, N P 2021, ' Robotic complete mesocolic excision with central vascular ligation for right colonic tumours – a propensity score-matching study comparing with standard laparoscopy ', BJS Open, vol. 5, no. 2, zrab016, pp. 1-7 . https://doi.org/10.1093/bjsopen/zrab016 BJS Open |
| ISSN: | 2474-9842 |
| DOI: | 10.1093/bjsopen/zrab016 |
| Popis: | Background Laparoscopic complete mesocolic excision (CME) of the right colon with central vascular ligation (CVL) is a technically demanding procedure. This study retrospectively evaluated the feasibility, safety and oncological outcomes of the procedure when performed using the da Vinci® robotic system. Methods A prospective case series was collected over 3 years for patients with right colonic cancers treated by standardized robotic CME with CVL using the superior mesenteric vessels first approach. The CME group was compared to a 2 : 1 propensity score-matched non-CME group who had conventional laparoscopic right colectomy with D2 nodal dissection. Primary outcomes were total lymph node harvest and length of specimen. Secondary outcomes were operative time, postoperative complications, and disease-free and overall survival. Results The study included 120 patients (40 in the CME group and 80 in the non-CME group). Lymph node yield was higher (29 versus 18, P = 0.006), the specimen length longer (322 versus 260 mm, P = 0.001) and median operative time was significantly longer (180 versus 130 min, P Conclusion Robotic CME with CVL is feasible and, although currently associated with a longer operation time, it provides good specimen quality, higher lymph node yield and acceptable morbidity, with a disease-free survival advantage. |
| Databáze: | OpenAIRE |
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