Kompletní mezokolická excise u pravostranné hemikolektomie
| Title in English | Complete mesocolic excision during right hemicolectomy |
|---|---|
| Authors | |
| Year of publication | 2016 |
| Type | Article in Periodical |
| Magazine / Source | Rozhledy v chirurgii |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.prolekare.cz/casopisy/rozhledy-v-chirurgii/2016-10/kompletni-mezokolicka-excize-u-pravostranne-hemikolektomie-59579 |
| Field | Surgery incl. transplantology |
| Keywords | right-sided hemicolectomy; complete mesocolic excision; colon cancer; lymphadenectomy |
| Description | introduction: Complete mesocolic excision (CME) ensures tne removal of all sentinel and regionaí iymph nodes during colon cancer surgery. For right-sided hemicolectomy it isessentiaí todissectthe walí of véna mesenterica superior, which increasesthe riskof injuring surrounding organ s. So far, no randomized studies comparing long-term oncological results of standard right hemicoíectomy and hemicolectomy with CME háve been published. Method: 83 patients operated for colon carcinoma in 2014 and 2015 were included in this study, all of them undergoing right-sided hemicolectomy using laparotomy access.The standard proceduře was doně in 63 cases and hemicolectomy with CME was doně in 20 cases. We compared tne incidence of complications, and the characteristics and descriptions of obtained specimensevaluated by a pathologistfor bothgroups. ftesu/fs:The operation times of right-sided hemicolectomies with CME was longer by 20 minutes on average. The incidence of postoperative complications was similar in both groups. Pancreatic fistula in the group of patients undergoing right-sided hemicolectomy with CME was an unusual complication; the fistula was healed through conservative treatment. Comparing the resecate parameters, we found no significant differences in the lengths of the resected terminál ileum. But the length of the resected colon was significantly longer for the CME technique (medián 42 cm versus 22 cm).The incidence of Iymph node metastases was similar in both groups. However, the total number of removed Iymph nodes in the group with CME was significantly higher (medián 23). Condusion: Right-sided hemicoiectomy with complete mesocolic excision offers the removal of more Iymph nodes than the standard technique. The centrál vascular ligation technique elongates the operation time and may be associated with more intraoperative injuries. Introduction of the concept of complete mesocolic excision is derived from an effort to standardize the surgical technique for colon cancer resection. |