부산대학교 도서관

Purpose: Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infre- quently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME col- ectomy compared to standard colectomy for right-sided colon cancer in a Western series. Methods: Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were com- pared to the ones of 55 patients who underwent laparoscopic standard right colectomy. Results: No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P=0.708), and unplanned readmission in 5.0% vs. 5.5% (P=1) after CME and standard colec- tomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), prox- imal (P=0.018), and distal margins (P=0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037). Conclusion: In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to ob- tain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.