Robotic complete mesocolic excision for transverse colon cancer can be performed with a morbidity profile similar to tha
- PDF / 859,182 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 43 Downloads / 176 Views
ORIGINAL ARTICLE
Robotic complete mesocolic excision for transverse colon cancer can be performed with a morbidity profile similar to that of conventional laparoscopic colectomy V. Ozben1 · C. de Muijnck1 · B. Sengun2 · S. Zenger2 · O. Agcaoglu2 · E. Balik2 · E. Aytac1 · I. A. Bilgin1 · B. Baca1 · I. Hamzaoglu1 · T. Karahasanoglu1 · D. Bugra2 Received: 26 March 2020 / Accepted: 19 May 2020 © Springer Nature Switzerland AG 2020
Abstract Background In minimally invasive surgery, complete mesocolic excision (CME) for transverse colon cancer is challenging; thus, non-CME resections are commonly preferred when laparoscopy is used. Robotic technology has been developed to reduce the limitations of laparoscopy. The aim of our study was to evaluate whether robotic CME for transverse colon cancer can be performed with short-term outcomes similar to those of laparoscopic conventional colectomy (CC). Methods A retrospective review of 118 consecutive patients having robotic CME or laparoscopic CC for transverse colon cancer in two specialized centers between May 2011 and September 2018 was performed. Perioperative 30-day outcomes of the two procedures were compared. Results There were 38 and 80 patients in the robotic CME group and laparoscopic CC group, respectively. The groups were comparable regarding preoperative characteristics. Intraoperative results were similar, including blood loss (median 50 vs 25 ml), complications (5.3% vs 3.8%), and conversions (none vs 7.5%). The rate of intracorporeal anastomosis was significantly higher (86.8% vs 20.0%), mean operative time was longer (325.0 ± 123.2 vs 159.3 ± 56.1 min (p 3 and emergency colectomy procedures. Transverse colon cancer was defined as a tumor located between the hepatic and splenic flexures, including the flexures. Patients with a transverse colon and a synchronous colon tumor requiring ligation of the middle colic artery were also included. Data collected were preoperative clinical characteristics, intraoperative and postoperative 30-day outcomes, and pathologic results. Data were compared between the robotic CME and laparoscopic CC groups. Preoperative characteristics included age, sex, body mass index (BMI), ASA score, co-morbidities, previous abdominal surgery, tumor location, and the presence of a synchronous tumor. Operative variables included type of surgical procedure, type of anastomosis (intra- or extracorporeal), anastomotic technique (stapled/handsewn), operative time, blood loss,
13
Techniques in Coloproctology
stoma status, concurrent procedures, conversions, and complications. Postoperative 30-day outcomes were time to first bowel movement and soft diet intake, anastomotic leak, ileus, hemorrhage, blood transfusion, surgical site infections (SSIs), cardiac, pulmonary and urinary morbidities, length of hospital stay, reoperation, and mortality. Complications were classified based on the Clavien–Dindo classification scale [10]. Histopathologic data were disease stage, specimen length, length of surgical margins to tumor, t
Data Loading...
