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Langenbeck's Archives of Surgery

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01-08-2019 | Colectomy | Original Article

Complete mesocolic excision does not increase short-term complications in laparoscopic left-sided colectomies: a comparative retrospective single-center study

Authors: Maxime Dewulf, Alain Kalmar, Bert Vandenberk, Filip Muysoms, Barbara Defoort, Donald Claeys, Pieter Pletinckx

Published in: Langenbeck's Archives of Surgery | Issue 5/2019

Abstract

Background

Since the implementation of total mesorectal excision (TME) in rectal cancer surgery, oncological outcomes improved dramatically. With the technique of complete mesocolic excision (CME) with central vascular ligation (CVL), the same surgical principles were introduced to the field of colon cancer surgery. Until now, current literature fails to invariably demonstrate its oncological superiority when compared to conventional surgery, and there are some concerns on increased morbidity. The aim of this study is to compare short-term outcomes after left-sided laparoscopic CME versus conventional surgery.

Methods

In this retrospective analysis, data on all laparoscopic sigmoidal resections performed during a 3-year period (October 2015 to October 2018) at our institution were collected. A comparative analysis between the CME group—for sigmoid colon cancer—and the non-CME group—for benign disease—was performed.

Results

One hundred sixty-three patients met the inclusion criteria and were included for analysis. Data on 66 CME resections were compared with 97 controls. Median age and operative risk were higher in the CME group. One leak was observed in the CME group (1/66) and 3 in the non-CME group (3/97), representing no significant difference. Regarding hospital stay, postoperative complications, surgical site infections, and intra-abdominal collections, no differences were observed. There was a slightly lower reoperation (1.5% versus 6.2%, p = 0.243) and readmission rate (4.5% versus 6.2%, p = 0.740) in the CME group during the first 30 postoperative days. Operation times were significantly longer in the CME group (210 versus 184 min, p < 0.001), and a trend towards longer pathological specimens in the CME group was noted (21 vs 19 cm, p = 0.059).

Conclusions

CME does not increase short-term complications in laparoscopic left-sided colectomies. Significantly longer operation times were observed in the CME group.

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Title: Complete mesocolic excision does not increase short-term complications in laparoscopic left-sided colectomies: a comparative retrospective single-center study
Authors: Maxime Dewulf
Alain Kalmar
Bert Vandenberk
Filip Muysoms
Barbara Defoort
Donald Claeys
Pieter Pletinckx
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Colectomy
Colectomy
Published in: Langenbeck's Archives of Surgery / Issue 5/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-019-01797-8

At a glance: The STEP trials

Springer Medicine

Complete mesocolic excision does not increase short-term complications in laparoscopic left-sided colectomies: a comparative retrospective single-center study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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