Laparoscopic versus Open Complete Mesocolic Excision for Right Colon Cancer

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Colorectal Cancer Management

Background:

• Laparoscopic surgery is increasingly adopted for colorectal cancer.
• Laparoscopic colectomy with mesenteric excision (LCME) offers potential advantages over open colectomy with mesenteric excision (OCME).

Purpose of the Study:

• To evaluate the safety, feasibility, and oncologic outcomes of LCME compared to OCME for stage II or III colon cancer.

Main Methods:

• Retrospective comparison of patients undergoing LCME versus OCME.
• Analysis of operative time, blood loss, conversion rates, lymph node yield, recovery parameters, complications, overall survival (OS), and disease-free survival (DFS).

Main Results:

• LCME had longer operative times but less blood loss. Higher lymph node yield in LCME (P=0.010). Faster recovery (flatus, diet) and shorter hospital stay in LCME.
• Similar 3-year OS (78.2% vs 63.2%) and comparable DFS between LCME and OCME groups.
• Lower complication rate in LCME (14.7%) vs OCME (27.2%), though not statistically significant (P=0.252).

Conclusions:

• Laparoscopic CME right hemicolectomy is a safe and feasible procedure when performed by experienced surgeons.
• LCME demonstrates comparable long-term oncologic outcomes to OCME for stage II or III colon cancer, with potential benefits in recovery.