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01-02-2022 | Colectomy | Original Article

Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study

Authors: Marco Milone, Maurizio Degiuli, Nunzio Velotti, Michele Manigrasso, Sara Vertaldi, Domenico D’Ugo, Giovanni Domenico De Palma, and Italian Society of Surgical Oncology Colorectal Cancer Network (SICO CCN) group

Published in: Updates in Surgery | Issue 1/2022

Abstract

The role of minimally invasive surgery in the treatment of transverse colon cancer is still controversial. The aim of this study is to investigate the advantages of a totally laparoscopic technique comparing open versus laparoscopic/robotic approach. Three hundred and eighty-eight patients with transverse colon cancer, treated with a segmental colon resection, were retrospectively analyzed. Demographic data, tumor stage, operative time, intraoperative complications, number of harvested lymph nodes and recovery outcomes were recorded. Recurrences and death were also evaluated during the follow-up. No differences were found between conventional and minimally invasive surgery, both for oncological long-term outcomes (recurrence rate p = 0.28; mortality p = 0.62) and postoperative complications (overall rate p = 0.43; anemia p = 0.78; nausea p = 0.68; infections p = 0.91; bleeding p = 0.62; anastomotic leak p = 0.55; ileus p = 0.75). Nevertheless, recovery outcomes showed statistically significant differences in favor of minimally invasive surgery in terms of time to first flatus (p = 0.001), tolerance to solid diet (p = 0.017), time to first mobilization (p = 0.001) and hospital stay (p = 0.004). Compared with laparoscopic approach, robotic surgery showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.005) and tolerance to solid diet (p = 0.001). Finally, anastomosis evaluation confirmed the superiority of intracorporeal approach which showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.003) and tolerance to solid diet (p = 0.001); moreover, we recorded a statistical difference in favor of intracorporeal approach for infection rate (p = 0.04), bleeding (p = 0.001) and anastomotic leak (p = 0.03). Minimally invasive approach is safe and effective as the conventional open surgery, with comparable oncological results but not negligible advantages in terms of recovery outcomes. Moreover, we demonstrated that robotic approach may be considered a valid option and an intracorporeal anastomosis should always be preferred.

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Title: Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study
Authors: Marco Milone
Maurizio Degiuli
Nunzio Velotti
Michele Manigrasso
Sara Vertaldi
Domenico D’Ugo
Giovanni Domenico De Palma
and Italian Society of Surgical Oncology Colorectal Cancer Network (SICO CCN) group
Publication date: 01-02-2022
Publisher: Springer International Publishing
Keywords: Colectomy
Colectomy
Minimally Invasive Surgery
Colon Cancer
Colon Cancer
Published in: Updates in Surgery / Issue 1/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-021-01159-4

At a glance: The STEP trials

Springer Medicine

Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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