Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Bae. Keimyung University and Dongsan Medical Center
Purpose: We present a video presentation of robotic complete mesocolic excision and paraaortic lymph node dissection for ascending colon cancer and paraganglioma.
Methods: A 79-year-old man was referred to our department for treatment of a cecal cancer. Colonoscopy revealed a 6-cm, ulcerofungating mass at cecum with complete obstruction. An abdominal computed tomography and a radionuclide positron emission tomography scan of the torso using 18F-fluorodeoxyglucose revealed a hypermetabolic lesion in the cecum with enlarged lymph nodes in pericolic, ileocolic, and aortocaval area and a small metastatic lesion in the right hepatic lobe. The patient underwent robotic right hemicolectomy with right paraaortic lymph node dissection and laparoscopic excision of diaphragmatic seeding nodule.
Results: Total procedure time was 490 minutes. Pathologic examination of the specimen showed a 6.0 × 5.5 cm sized moderately differentiated T4bN1bM1b adenocarcinoma. The numbers of total and positive lymph nodes harvested were 26 and 3, respectively. Among the 3 apical lymph nodes, there was no positive lymph node at the central area. The excised 4 paraaortic lymph nodes were diagnosed as paraganglioma without margin involvement. A diaphragmatic nodule close to right liver revealed metastatic adenocarcinoma. The proximal and distal resection margins were 43 and 55, respectively. The patient was discharged on postoperative day 10 without postoperative complication.
Conclusion: Robotic complete mesocolic excision and paraaortic lymph node dissection for ascending colon cancer could be performed safely with accurate staging and diagnosis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88402
Program Number: V023
Presentation Session: Colorectal 1 Session
Presentation Type: Video