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Published in: Langenbeck's Archives of Surgery 1/2015

01-01-2015 | How-I-Do-It article

Cranially approached radical lymph node dissection around the middle colic vessels in laparoscopic colon cancer surgery

Authors: Takeru Matsuda, Takeshi Iwasaki, Masaaki Mitsutsuji, Kenro Hirata, Yoko Maekawa, Daisuke Tsugawa, Yutaka Sugita, Yasuo Sumi, Etsuji Shimada, Yoshihiro Kakeji

Published in: Langenbeck's Archives of Surgery | Issue 1/2015

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Abstract

Purpose

Laparoscopic lymph node (LN) dissection around the middle colic vessels is technically demanding, thus raising controversy regarding the role of laparoscopic surgery for transverse colon cancer. We herein describe a cranial approach method to perform radical LN dissection around the middle colic vessels. The key characteristic of this approach is early division of middle colic vessels prior to mobilization of the colon.

Methods

From April 2010 to September 2013, 27 patients with colon cancer received laparoscopic LN dissection around the middle colic vessels using this cranial approach. Their surgical and short-term outcomes were reviewed.

Results

The mean number of harvested LNs was 29 (range, 6–50). The mean operative time and intraoperative blood loss were 274 min (range, 160–362 min) and 42 mL (range, 3–247 mL), respectively. There were no serious intraoperative complications or conversions to open surgery. There were two patients with stage 0, 7 with stage I, 12 with stage II, and 6 with stage III. No recurrent case was observed with a median follow-up period of 30 months (range, 9–48 months).

Conclusions

We consider this approach feasible and useful for radical LN dissection around the middle colic vessels during laparoscopic colon cancer surgery.
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Metadata
Title
Cranially approached radical lymph node dissection around the middle colic vessels in laparoscopic colon cancer surgery
Authors
Takeru Matsuda
Takeshi Iwasaki
Masaaki Mitsutsuji
Kenro Hirata
Yoko Maekawa
Daisuke Tsugawa
Yutaka Sugita
Yasuo Sumi
Etsuji Shimada
Yoshihiro Kakeji
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 1/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-014-1250-2

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