Toru Tonooka, Nobuhiro Takiguchi, Atsushi Ikeda, Hiroaki Soda, Isamu Hoshino, Hisashi Gunji, Arihito Yoshizumi, Yoshihiro Nabeya. Chiba Cancer Center
Aim: Laparoscopic surgery for right-sided colon carcinoma is difficult to standardize due to technical difficulty by the presence of adjacent organs and major vessels to be preserved. There are different approaches to overcome the hurdle, such as cranial first, median first and retroperitoneal first approach, although leading to difficulty in formulating the procedure standardization. The aim of this study is to verify the validity of the cranial first approach in laparoscopic right-sided colon cancer surgery.
Method: From 2013 to 2017, either laparoscopic ileocecal resection or laparoscopic right hemicolectomy was performed for 26 cases of right-sided colon cancer patients. We created the three dimensional CT angiography for preoperative simulation, and all cases were performed in cranial first approach procedure. We evaluated the clinicopathological findings and the accomplishment rate of the procedure.
Results: All 26 cases were accomplished by the laparoscopic surgery and there was no conversion to open surgery. The median operative time and blood loss were 205 min and 19 ml, respectively. The median number of harvested LNs was 30. There were 5 cases with positive LN metastasis. The median length of stay was eight days. There was no major complication and postoperative course was uneventful in all cases.
Conclusion: Laparoscopic right-sided colon cancer surgery was safely performed in cranial first approach. From the accomplishment rate and the quality of the surgical result, the validity of the cranial first approach was confirmed.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95040
Program Number: P360
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster