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Surgical outcome of laparoscopic surgery for right colon cancer: single institute experience

Shinobu Ohnuma, Takeshi Naitoh, MD, Hideaki Karasawa, MD, Atsushi Kohyama, MD, Hideyuki Suzuki, MD, Kazuhiro Watanabe, MD, Hirofumi Imoto, MD, Akihiro Yamamura, MD, Takeshi Aoki, MD, Naoki Tanaka, MD, Hiroaki Musha, MD, Takanori Morikawa, MD, Fuyuhiko Motoi, MD, Takashi Kamei, MD, Takanori Ishida, MD, Michiaki Unno, MD. Tohoku University Hospital

Aim: The aim of this study is to investigate surgical outcome of the patients with laparoscopic surgery for right colon cancer in single institute.

Methods: One-hundred thirty-four patients (M : F = 63 : 71, median age, 72 years) who had laparoscopic surgery for right colon cancer (Stage 0 – III) from October 2008 to July 2018 were retrospectively analyzed. The median follow-up period was 36 months.

Results: The pathological disease stage (pStage) was 0 (n = 7), I (n = 43), IIA (n = 40), IIB (n = 6), IIC (n = 2), IIIA (n = 7), IIIB (n = 25), and IIIC (n = 4), respectively (TNM7th). Operative time, blood loss, and postoperative hospital stay were 212 min (93 – 453), 42.5 g (1 – 695), and 10 days (5 – 72), respectively (median). Postoperative complications (Clavien-Dindo above grade II) were observed in 16 patients (11.9%). One patient (0.7%) required conversion to a laparotomy. The number of patients with recurrence was 9 (6.7%), whose pStages were IIA (n = 1), IIB (n = 2), IIIA (n = 2), IIIB (n = 3), and IIIC (n = 1), respectively. Among them, initial recurrence was observed in liver (n = 4), para-aortic lymph node (n = 2), peritoneum (n = 1), brain (n = 1), and port site (n = 1). Those recurrences were diagnosed within 1 year (n = 4), 2 years (n = 3), and 3 years (n = 2), respectively. The liver metastases of two patients and a port-site recurrence of one patient were surgically removed, and the brain metastasis in one patient were treated with Cyberknife. The remaining four patients with recurrence had chemotherapies, and two of those died of progressive disease. 5-years over-all survival rate and disease-free survival (DFS) rate of all patients were 98% and 91%. 5-years DFS of Stage IIA, IIB, IIC, IIIA, IIIB, and IIIC were 96.7%, 60.0%, 100%, 66.7%, 84.7%, and 66.7%, respectively. Lymphatic invasion, vascular invasion, and lymph node metastasis were significantly correlated with recurrence (p = 0.0005, 0.007, and 0.008) . 

Conclusions: Surgical outcome of laparoscopic surgery for right colon cancer is safe and feasible.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94501

Program Number: P327

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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