Abstract
Background: Complete mesocolic excision (CME) with central vessel ligation (CVL) as performed in Erlangen offers the best long-term outcomes for colon cancer. The aim of the study was to assess the specimens after laparoscopic vs open CME-CVL macroscopically and morphometrically in patients with left and right colon cancers.
Patients-Methods: All specimens were freshly photographed. Precise tumor morphometry and grading of the surgical plane were performed as described by pathologists in Leeds-UK.
Results: 34 specimens from right-sided cancers were divided into 18 transverse colon cancers (9 lap vs 9 open) and 16 caecum-ascending colon cancers (7 lap vs 9 open) and 56 specimens from left-sided cancers (33 lap vs 23 open). There was no difference between laparoscopically and open acquired left- and right-sided specimens. Specimens of transverse colon displayed differences in length of central ligation to tumor (open 11.67cm vs lap 8.72cm, p=0.049), length of central ligation to bowel wall (open 9.11cm vs lap 6.5cm, p=0.015) and lymph node clearance (open 46.33 vs lap 39.33, p=0.033).
Conclusion: Laparoscopy seems to offer specimens of similar quality after CME-CVL surgery for colon cancer as the open approach. Issues of completeness of excision from laparoscopy are raised for tumors located in the transverse colon.
© 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland
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