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Surgical Endoscopy

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01-07-2016

Mesenteric root dissection with individualized ileo-colic vessel ligation versus mesenteric pedicle stapling

Authors: Ilan Kent, Yaron Rudnicki, Yasmin Abu-Ghanem, Ian White, Baruch Spitz, Shmuel Avital

Published in: Surgical Endoscopy | Issue 7/2016

Abstract

Background

Numerous factors have been associated with the number of lymph nodes retrieved during laparoscopic colectomy. This study compared the impact of vascular pedicle ligation method on the number of retrieved lymph nodes in patients undergoing laparoscopic right hemicolectomy for cancer. Mesenteric root dissection with individualized vessel ligation was compared to en bloc vascular root stapling.

Methods

Data were retrospectively collected from a database of patients’ charts including operative and pathological reports. All patients that underwent laparoscopic colectomy in a single department were identified. Patients that underwent elective laparoscopic right hemicolectomy for cancer were further evaluated. The impact of the method used for ileo-colic vascular transection, age, gender, nodes status, T stage, BMI and the operating surgeon on the number of retrieved lymph nodes was studied.

Results

Among 239 laparoscopic colectomies, 75 patients underwent elective laparoscopic right colectomy for cancer. Ileo-colic vascular transection was routinely performed at the level of the inferior border of the pancreas. In total, 34 patients underwent ileo-colic vascular root dissection with individualized vessel ligation and 41 underwent vascular root stapling. No difference was found in the mean number of retrieved lymph nodes between pedicle dissection and vascular root stapling (18.7 ± 5.9 vs. 19.6 ± 7.9, P = 0.396), and in the rate of patients who had 12 nodes or more (97.1 vs. 92.7 %, P = 0.401). BMI above 30 was associated with decreased number of retrieved nodes (P = 0.001).

Conclusions

No difference was found in the number of retrieved lymph nodes between ileo-colic vascular root dissection with individual vessel ligation and vascular root stapling in patients undergoing laparoscopic right hemicolectomy for cancer. High BMI was associated with decreased number of retrieved nodes in both groups. A standard approach regarding the level of mesenteric root transection, regardless of the ligation approach, leads to adequate lymph node harvesting by different surgeons.

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Title: Mesenteric root dissection with individualized ileo-colic vessel ligation versus mesenteric pedicle stapling
Authors: Ilan Kent
Yaron Rudnicki
Yasmin Abu-Ghanem
Ian White
Baruch Spitz
Shmuel Avital
Publication date: 01-07-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 7/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4593-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mesenteric root dissection with individualized ileo-colic vessel ligation versus mesenteric pedicle stapling

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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