Morphometric analysis and lymph node yield in laparoscopic complete mesocolic excision performed by supervised trainees  

Oleh:

West, N.P. ; Kennedy, R.H. ; Magro, T. ; Luglio, G.

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 11 (Oct. 2014), page 1460-1467.
Topik: colonic cancer; kanker usus besar; rectal cancer; standardized surgery; rectal tumours; european countries; cancer surgery; operasi kanker; colorectal surgery

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Perpustakaan FK Nomor Panggil: B15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Complete mesocolic excision with central vascular ligation (CME) produces an optimal colonic cancer specimen. The ability of expert laparoscopic surgeons to produce equivalent specimens is unknown. Methods Fresh specimen photographs and clinicopathological data from patients undergoing laparoscopically assisted CME at St Mark's Hospital, Harrow, were submitted for independent pathological review. Surgery was performed by a mixture of consultant specialists and trainees under consultant specialist supervision, between February 2010 and July 2011. The planes of surgery were graded and tissue morphometry was performed using standard methods. The results were compared with published data from open CME and non-CME surgery. Results In total, 69 patients were identified, and in 96 per cent resection was performed completely or partially by surgical trainees. Laparoscopic CME produced a similar specimen to open CME. The laparoscopic mesocolic plane resection rate was similar to that for open surgery (90 versus 88 per cent). The distance between the bowel wall and site of vascular division was similar for laparoscopic and open right-sided CME (92 versus 95?mm respectively). The corresponding values for left-sided CME were also similar (103 versus 107?mm). Compared with values from two non-CME series, laparoscopic CME had a higher mesocolic plane rate (90 versus 40 and 48 per cent), and resected more tissue between the bowel wall and the vascular division (right-sided: 92 versus 72 and 76?mm; left-sided: 103 versus 85 and 70?mm). The lymph node yield remained low following laparoscopic CME compared with open CME (median 18 versus 32; P?

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