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Totally robotic modified complete mesocolic excision and central vascular ligation for right-sided colon cancer: technical feasibility and mid-term oncologic outcomes

Authors
 Sung Uk Bae  ;  Seung Yoon Yang  ;  Byung Soh Min 
Citation
 INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol.34(3) : 471-479, 2019-03 
Journal Title
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
ISSN
 0179-1958 
Issue Date
2019-03
MeSH
Adult ; Aged ; Aged, 80 and over ; Colectomy ; Colonic Neoplasms / blood supply* ; Colonic Neoplasms / pathology ; Colonic Neoplasms / surgery* ; Digestive System Surgical Procedures / methods* ; Feasibility Studies ; Female ; Humans ; Ligation ; Male ; Middle Aged ; Neoplasm Recurrence, Local / pathology ; Postoperative Care ; Robotic Surgical Procedures / methods* ; Treatment Outcome
Keywords
Complete mesocolic excision ; Robotic modified CME ; Colon cancer
Abstract
Background Recently, an operative strategy involving complete mesocolic excision (CME) and central vascular ligation (CVL) for colonic cancer has been introduced. We aimed to describe our initial experience and assess the long-term outcomes of robotic modified CME (mCME) and CVL (mCME+CVL) for right-sided colon cancer. Methods Of the 677 patients with histologically confirmed, right-sided colon adenocarcinoma who underwent curative mCME+CVL between February 2008 and October 2016, 43 who were treated entirely using the robotic approach were included in this retrospective study. Survival rates were determined using the Kaplan-Meier method, and P values of <0.05 indicated statistically significant differences. Results The total operation and docking times were 293 (180-644) min and 5 (3-19) min, respectively, with an estimated blood loss of 50 (10-400) mL. The time to soft diet was 4 (1-16) days and the length of hospitalization was 8 (4-48) days. Based on the Clavien-Dindo classification, grade I, II, IIIa, IIIb, and IV complications were noted in 3 (7.0%), 5 (11.7%), 2 (4.7%), 1 (2.3%), and 0 (0%) patients, respectively. The proximal and distal resection margins were 14 (4-54) and 19 (4-48) cm, respectively, and 29 (6-157) lymph nodes were harvested per patient. The patients were followed-up for a median of 55 (2-109) months, during which the overall survival rate, median disease-free period, disease-free survival rate, and tumor recurrence rate were 93.6%, 38 (2-109) months, 81.1%, and 16.3% (7 patients), respectively. Conclusions Robotic mCME and CVL for right-sided colon cancer was feasible and safe. It can be added to the surgeon's toolbox as an optional strategy for the management of colon cancer patients.
Full Text
https://link.springer.com/article/10.1007/s00384-018-3208-2
DOI
10.1007/s00384-018-3208-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Bae, Sung Uk(배성욱)
Yang, Seung Yoon(양승윤) ORCID logo https://orcid.org/0000-0001-8129-7712
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189157
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