Robotic Right Colectomy with Modified Complete Mesocolic Excision: Long-Term Oncologic Outcomes

Ann Surg Oncol. 2016 Dec;23(Suppl 5):684-691. doi: 10.1245/s10434-016-5580-x. Epub 2016 Oct 3.

Abstract

Background: A modified complete mesocolic excision (mCME) technique for the treatment of right-sided colon cancer recently was shown by Hohenberger and colleagues to provide impressive long-term oncologic outcomes. This report aims to describe the authors' experience with robotic right colectomy using mCME. The safety, feasibility, and efficacy of this procedure are measured by complications, conversion rates, and 4-year oncologic outcomes.

Methods: A retrospective study analyzed 100 consecutive patients who underwent robotic right colectomy with mCME and intracorporeal anastomosis at the authors' institution between November 2005 and November 2013. Intra- and postoperative clinical outcomes, pathologic data, and survival were analyzed.

Results: Robotic right colectomy with mCME was successfully performed for all the patients. No conversions or intraoperative complications occurred. The major complication rate (Dindo 3 or 4) was 4 %. During a median follow-up period of 48.5 months (range 24-114 months), the survival rates were 94.5 % for disease-specific survival, 91.4 % for disease-free survival, and 90.3 % for overall survival.

Conclusions: The authors' experience confirms the feasibility and safety of mCME for the treatment of right-sided colon cancer. This technique provided satisfying short-term outcomes with promising 4-year oncologic results. However, the real benefits of the CME technique should be evaluated further by well-conducted randomized studies before its adoption in routine practice is recommended.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomotic Leak / etiology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Colectomy / adverse effects
  • Colectomy / methods*
  • Colonic Neoplasms / drug therapy
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Conversion to Open Surgery
  • Disease-Free Survival
  • Feasibility Studies
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Hemoperitoneum / etiology
  • Humans
  • Intraoperative Complications / etiology
  • Leucovorin / administration & dosage
  • Male
  • Mesocolon / surgery*
  • Middle Aged
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Retrospective Studies
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Survival Rate
  • Time Factors

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Leucovorin
  • Fluorouracil