کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5731010 1611468 2017 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
پیش نمایش صفحه اول مقاله
Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome
چکیده انگلیسی


- To analyze laparoscopic total right Mesocolectomy.
- Overall, disease free and disease specific survival were 83%, 78.3% and 79.5% respectively.
- Laparoscopic Mesocolectomy showed to be safe, with significant impact on survival.

BackgroundTo analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers.Methods600 consecutive patients were studied.ResultsMortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 mm and mean lymph nodes harvested was 27 ± 3; mesocolic plane was achieved in 81% of cases. Survival was 83%; stratified survival in patients with stage II, IIIA/B and in the subgroup of stage IIIC patients with negative apical nodes was 88.7%, 72.4%, 71.4% respectively; stage IIIC patients with positive apical nodes showed poor survival (27.7%). Recurrence occurred in 177 patients (29.5%) and was mainly systemic (22.7%). At the multivariate analysis, “non mesocolic” plane of resection, positive N3 apical nodes and CEA levels >5 ng/dL were found to be independent prognostic factors.ConclusionsLaparoscopic right Mesocolectomy showed to be safe and yielded surgical specimens of high quality, with impact on survival; positive N3 apical nodes and “non mesocolic” planes were independently associated to poor outcome.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The American Journal of Surgery - Volume 214, Issue 2, August 2017, Pages 222-227
نویسندگان
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