The goal of this observational comparative study is to assess whether laparoscopic complete mesocolic excision with central vascular ligation (L-CME with CVL) provides improved short-term surgical outcomes compared with open complete mesocolic excision with central vascular ligation (O-CME with CVL) in patients with right-sided colon cancer.
The primary questions this study aims to answer are:
Does laparoscopic CME with CVL reduce blood loss, postoperative complications, and length of hospital stay compared with open CME?
Does laparoscopic CME with CVL achieve equivalent surgical specimen quality and short-term oncological outcomes compared to the open approach?
Researchers compared laparoscopic versus open right hemicolectomy with CME and CVL in adult patients diagnosed with right colon cancer who were eligible for elective surgical resection.
Participants underwent standard preoperative assessment, including clinical evaluation, laboratory testing, imaging studies, colonoscopy, and biopsy confirmation. Surgical treatment consisted of either laparoscopic or open complete mesocolic excision with central vascular ligation, performed according to standardized oncologic surgical principles. Postoperative care followed an enhanced recovery protocol.
Primary outcome measures included operative time, intraoperative blood loss, time to first flatus, postoperative complications, and duration of hospital stay. Secondary outcomes included quality of the surgical specimen (lymph node yield, mesocolic integrity, and margin status) and short-term oncologic outcomes, including early recurrence during follow-up.
rt cancer colon
metastatisis
Parallel
right hemicolectomy laparoscopic surgery
Procedure/SurgeryLaparoscopic right hemicolectomy or extended right hemicolectomy using complete mesocolic excision with central vascular ligation, pneumoperitoneum 12-14 mmHg via umbilical port, diamond-shaped port placement, medial-to-lateral dissection along embryological planes, ligation of ileocolic (and right colic/middle colic branch when indicated) at origin, intra- or extracorporeal stapled ileotransverse anastomosis, specimen extraction through Pfannenstiel or right subcostal incision, standard perioperative care.
open rt hemicolectmy
Procedure/SurgeryOpen right hemicolectomy or extended right hemicolectomy using complete mesocolic excision with central vascular ligation, via midline laparotomy, lateral-to-medial mobilization, ligation of ileocolic (and right colic/middle colic branch when indicated) at origin, extracorporeal ileotransverse anastomosis with hand-sewn sutures, standard perioperative care.
Length of Postoperative Hospital Stay
Number of days from the date of surgery to the date of hospital discharge.
Overall Postoperative Morbidity ( Incidence of postoperative complications)
Occurrence of any postoperative complication, including wound infection, anastomotic leak, abdominal collection, pulmonary infection, urinary tract infection, or deep vein thrombosis, occurring within the early postoperative period.
Intraoperative Blood Loss ( Estimated blood loss (milliliters))
Volume of blood lost during surgical resection, measured intraoperatively.
Operative Time ( Duration of surgery (minutes))
Time from skin incision to skin closure.
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