Related Experiment Video
Updated: Jul 16, 2025
08:26
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
523
Intracorporeal Vessel Ligation in Laparoscopic Right Colectomy for Cancer is Associated with Increased Lymph Node
Zoe Garoufalia1, Sameh Hany Emile1,2, Rachel Gefen1,3
1Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
World Journal of Surgery
|September 20, 2023
Summary
Intracorporeal vascular pedicle division in laparoscopic right colectomy yields more lymph nodes and longer specimens. However, it requires longer operative times, with similar short-term outcomes compared to extracorporeal division.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic right colectomy is a standard procedure for colorectal cancer.
- Division of the vascular pedicle can be performed intracorporeally or extracorporeally.
- The optimal method for vascular pedicle division remains debated.
Purpose of the Study:
- To compare intracorporeal versus extracorporeal vascular pedicle division in laparoscopic right colectomy.
- To evaluate differences in pathological outcomes, short-term morbidity, and oncological recurrence.
Main Methods:
- Retrospective analysis of 271 patients undergoing laparoscopic right colectomy for cancer (01/2011-08/2021).
- Comparison of intracorporeal (n=171) versus extracorporeal (n=100) vascular pedicle division.
- Outcomes assessed included lymph node yield, specimen length, R1 rate, positive lymph node ratio, morbidity, recurrence, and metastases.
Main Results:
- Intracorporeal division was associated with a higher mean lymph node yield (28.6 vs. 25.4, p=0.04) and longer resected colon length (26.0 vs. 23.0 cm, p=0.003) when matched for resection extent.
- Intracorporeal division required significantly longer operative times (168.9 vs. 139.7 min, p=0.001).
- No significant differences were observed in ileus, hemorrhage, surgical site infection, re-operation rates, local recurrence, or distant metastases.
Conclusions:
- Intracorporeal vascular pedicle division in laparoscopic right colectomy enhances lymph node harvest and specimen length.
- Despite longer operative times, intracorporeal division demonstrates comparable short-term postoperative clinical outcomes to extracorporeal division.
