title: Short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision and central ligation.
abstract: OBJECTIVE
  To evaluate the pathologic, short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision (CME) and central ligation for right-sided colon cancer.
  
  
  METHODS
  All patients (n = 215) underwent elective CME either by open surgery (n = 99) or laparoscopy (n = 116).
  
  
  RESULTS
  Mean number of retrieved lymph nodes (31 vs. 27, p = 0.012) was greater in the open CME group. Between the open and laparoscopic CME groups, there were no differences of length of the specimen (44.3 cm and 43.2 cm), ileum (14 cm and 13.3 cm), or colon (30.3 cm and 29.8 cm), respectively. Proximal and distal margins were similar. Mean operative time was similar between the open and laparoscopic CME groups (175 min vs. 178 min). The rate of 30-day postoperative complications (36.4% vs. 23.3%, p = 0.036) was higher in the open CME group. There were no differences in 3-year overall survival rates (86.9% vs. 95.5% in stage II disease and 70.2% vs. 90.7% in stage III disease) or recurrence-free survival rates (84.5% vs. 84.8% in stage II disease and 64.2% vs. 68.9% in stage III disease) between the open and laparoscopic CME groups.
  
  
  CONCLUSIONS
  Pathologic (specimen lengths, resection margin lengths, number of lymph nodes, and R0 resection) and oncologic outcomes of the laparoscopic CME group were comparable. Moreover, laparoscopic CME conferred short-term benefits in terms of lower rates of postoperative complications, reduced time to soft diet, and reduced length of hospital stay. Based on these results, laparoscopic CME can be considered as a routine elective approach for right-sided colon cancer.
authors: Department of Surgery, Division of Gastrointestinal Surgery, Yonsei University Wonju College of Medicine, Wonju, South Korea.
authors: Ik Yong
authors: IY
authors: Kim
authors: Department of Internal Medicine, Division of Gastroenterology, Yonsei University Wonju College of Medicine, Wonju, South Korea.
authors: Bo Ra
authors: BR
authors: Kim
authors: Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
authors: Eun Hee
authors: EH
authors: Choi
authors: Department of Surgery, Division of Gastrointestinal Surgery, Yonsei University Wonju College of Medicine, Wonju, South Korea. Electronic address: youngwkim@yonsei.ac.kr.
authors: Young Wan
authors: YW
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008026:Ligation; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008646:Mesocolon / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colonic neoplasms; Laparoscopy; Mesocolic excision; Morbidity; Survival rate