Abstract
Background: Complete mesocolic excision (CME) has been proposed for better local control of colon cancer and to improve cancer‐specific survival. However, CME is associated with specific morbidities such as intra‐ and postoperative bleeding due to the high ligation of vessels. Whether CME truly offers oncological superiority is still debated. We reviewed the outcome of our pragmatic right hemicolectomies characterised by ‘as high as possible’ vessel ligation.
Methods: All right hemicolectomies (emergency and elective) at a specialist tertiary unit performed during the five‐year period (2011–2015) were reviewed, using prospectively collected cancer‐specific data and retrospective collection of clinical data.
Results: During the 5‐year period 709 patients underwent a right hemicolectomy for cancer (372 (52.5%) female, median age 73 years, range 30–100 years): 73.2% of the operations were elective and 40.3% were performed laparoscopically.
Of the 519 elective operations, 50.3% were done laparoscopically. In 90.9% of the cases, 12 or more lymph nodes were harvested with no difference between an open (89.9%) or laparoscopic (92.0%) approach (P = 0.42). There were only 4 peri‐operative bleeds (0.77%).
At a median follow‐up of 47 months, 405 patients (78.0%) were surviving disease‐free. The overall locoregional recurrence rate was 6.6% and distant recurrence was 15.4%. Overall 30‐day mortality was 2.1% while 3‐year mortality was 25.4%. Cancer‐specific 3‐year mortality was 14.2%.
Conclusion: Pragmatic right hemicolectomy offers acceptable recurrence rate with few bleeding complications. There is an ongoing analysis of further data for details of morbidities/mortalities as well as decision makings regarding adjuvant therapy.
Methods: All right hemicolectomies (emergency and elective) at a specialist tertiary unit performed during the five‐year period (2011–2015) were reviewed, using prospectively collected cancer‐specific data and retrospective collection of clinical data.
Results: During the 5‐year period 709 patients underwent a right hemicolectomy for cancer (372 (52.5%) female, median age 73 years, range 30–100 years): 73.2% of the operations were elective and 40.3% were performed laparoscopically.
Of the 519 elective operations, 50.3% were done laparoscopically. In 90.9% of the cases, 12 or more lymph nodes were harvested with no difference between an open (89.9%) or laparoscopic (92.0%) approach (P = 0.42). There were only 4 peri‐operative bleeds (0.77%).
At a median follow‐up of 47 months, 405 patients (78.0%) were surviving disease‐free. The overall locoregional recurrence rate was 6.6% and distant recurrence was 15.4%. Overall 30‐day mortality was 2.1% while 3‐year mortality was 25.4%. Cancer‐specific 3‐year mortality was 14.2%.
Conclusion: Pragmatic right hemicolectomy offers acceptable recurrence rate with few bleeding complications. There is an ongoing analysis of further data for details of morbidities/mortalities as well as decision makings regarding adjuvant therapy.
| Original language | English |
|---|---|
| Article number | 118 |
| Journal | Colorectal Disease |
| Volume | 22 |
| Issue number | s1 |
| DOIs | |
| Publication status | Published - 6 Jul 2020 |