Complete Mesocolic Excision Via Med to Lateral Approach in Open Right
Hemicolectomy and the Benefits of this Approach
Tamer M El-Gaabary, Ghada Morshed* and Sameh M Samir
Department of Surgery, Faculty of Medicine, Fayoum University, Egypt
*Corresponding Author: Ghada Morshed, Department of Surgery, Faculty of Medicine, Fayoum University, Egypt.
August 17, 2022; Published: August 23, 2022
Background: The common approach used in open right hemicolectomy is lateral-to-medial approach (LA). With the start of minimal access techniques, laparoscopic surgeons used the medial-to-lateral approach (MA).
Aim: The objective of the present study was to evaluate the medial to lateral approach in patients who underwent right open hemicolectomy with total mesocolic excision and the benefits of this approach.
Patients and Methods: This is a prospective study included 20 patients with cancer right colon.
Results: Mean operative time was 68 minutes (range 53 minutes - 70 minutes), the colon was successfully transected in all patients, no postoperative anastomotic leakage occurred, and pathologic assessment revealed free distal margins and circumferential margins for all patients.
Conclusion: In the current study, MA provided short operative time and low blood loss, safe total meso rectal excision in open right hemicolectomy and it is considered an improvement over the previously used LA approach.
Keywords: Complete Mesocolic Excision; Med to Lateral Approach; Open Right Hemicolectomy
- Torre LA., et al. “Global cancer statistics, 2012”. CA: A Cancer Journal for Clinicians 65 (2015): 87-108.
- Siegel R., et al. “Colorectal cancer statistics”. CA: A Cancer Journal for Clinicians 64 (2014): 104-117.
- Lee GH., et al. “Is right-sided colon cancer different to left-sided colorectal cancer?—a systematic review”. European Journal of Surgical Oncology 41 (2015): 300-308.
- Rotholtz NA., et al. “Laparoscopic colectomy: medial versus lateral approach”. Surgical Laparoscopy Endoscopy and Percutaneous Techniques 19 (2009): 43-47.
- Rondelli F., et al. “Is laparoscopic right colectomy more effective than open resection? A meta-analysis of randomized and nonrandomized studies”. Colorectal Disease 14 (2012): e447-e469.
- Green BL., et al. “Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer”. British Journal of Surgery 100 (2013): 75-82.
- Buunen M., et al. “Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial”. Lancet Oncology 10 (2009): 44-52.
- Adamina M., et al. “Laparoscopic complete mesocolic excision for right colon cancer”. Surgery Endoscopy 26 (2012): 2976-2980.
- Zheng MH., et al. “Long-term outcome of laparoscopic total mesorectal excision for middle and low rectal cancer”. Minimally Invasive Therapy and Allied Technologies 19 (2010): 329-339.
- West NP., et al. “Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon”. Journal of Clinical Oncology 28 (2010): 272-278.
- Liang JT., et al. “Comparison of medial-to-lateral versus traditional lateral-to-medial laparoscopic dissection sequences for resection of rectosigmoid cancers: randomized controlled clinical trial”. World Journal of Surgery 27 (2003): 190-196.
- Pigazzi A., et al. “Laparoscopic medial-to-lateral colon dissection: how and why”. Journal of Gastrointestinal Surgery 11 (2007): 778-782.
- Milsom JW., et al. “A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report”. Journal of the American College of Surgeons 187 (1998): 46-54, 54-55.
- Senagore AJ., et al. “Results of a standardized technique and postoperative care plan for laparoscopic sigmoid colectomy: a 30-month experience”. Diseases of the Colon and Rectum 46 (2003): 503-509.
- Ballantyne GH., et al. “Telerobotic-assisted laparoscopic right hemicolectomy: lateral to medial or medial to lateral dissection?” Surgical Laparoscopy Endoscopy and Percutaneous Techniques 16 (2006): 406-410.
- Veldkamp R., et al. “Laparoscopic resection of colon Cancer: consensus of the European Association of Endoscopic Surgery (EAES)”. Surgical Endoscopy 18 (2004): 1163-1185.
- Shin JW., et al. “Complete mesocolic excision with D3 lymph node dissection in laparoscopic colectomy for stages II and III colon cancer: long-term oncologic outcomes in 168 patients”. Techniques in Coloproctology 18 (2014): 795-803.
- Feng B., et al. “Laparoscopic complete mesocolic excision (CME) with medial access for right-hemi colon cancer: feasibility and technical strategies”. Surgical Endoscopy 26 (2012): 3669-3675.
- Han DP., et al. “Long-term results of laparoscopy-assisted radical right hemicolectomy with D3 lymphadenectomy: clinical analysis with 177 cases”. The International Journal of Colorectal Disease 28 (2013): 623-629.