Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis
Background The introduction of complete mesocolic excision (CME) with central vessel ligation (CVL) for right-sided colon cancer has improved oncologic outcomes. However, there is controversy over the oncologic safety of laparoscopic CME with CVL. This study compared short-term and long-term oncolog...
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| Veröffentlicht in: | Surgical endoscopy 2018-06, Vol.32 (6), p.2721-2731 |
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| creator | Shin, Jung Kyong Kim, Hee Cheol Lee, Woo Yong Yun, Seong Hyeon Cho, Yong Beom Huh, Jung Wook Park, Yoon Ah Chun, Ho-Kyung |
| description | Background
The introduction of complete mesocolic excision (CME) with central vessel ligation (CVL) for right-sided colon cancer has improved oncologic outcomes. However, there is controversy over the oncologic safety of laparoscopic CME with CVL. This study compared short-term and long-term oncologic outcomes between laparoscopic and open modified CME (mCME) with CVL in patients with right-sided colon cancer.
Methods
We enrolled 1239 patients who underwent open mCME with CVL and 1010 patients treated by a laparoscopic approach for right-side colon cancer between 2000 and 2013 and used 1:1 propensity score matching to adjust for potential baseline confounders between two groups.
Results
After propensity score matching, 683 patients who underwent open mCME with CVL were compared with 683 patients treated with a laparoscopic approach. There were no significant differences between these groups in age, sex, ASA score, TNM stage, tumor size, lymphovascular invasion, and perineural invasion. Comparison of open and laparoscopic mCME groups showed no significant difference in postoperative morbidity (21.4 vs. 18.3%,
p
= 0.175) and mortality (0.1 vs. 0%,
p
= 1.000). The laparoscopic mCME group showed shorter length of hospital stay. The 5-year overall survival rate was 83.7% in the open group and 94.7% in the laparoscopic group (
p
|
| doi_str_mv | 10.1007/s00464-017-5970-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5956070</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1960927199</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-f6e0affc34332a9a9fe7fa06b4e77c1a2c3c4b41e0cb1deac4853416e5d8fe973</originalsourceid><addsrcrecordid>eNp1UsuO1DAQjBCIHRY-gAuyxIWLwXaceHxBQite0khc4Gw5TifxKomD7ewy38hP0UOG5SFxst1dXdXtrqJ4ytlLzph6lRiTtaSMK1ppxWh9r9hxWQoqBN_fL3ZMl4wKpeVF8Sila4ZwzauHxYXQnPFKiV3x_WAXG0NyYfGOTKH1nYeWTJCCCyOG4JvzyYeZ3Po8EAdzjnYkNza5dbSRjL63-ZT2M4m-HzJNvkUCLMags7ODSNIQbhNpIOftETMldm4JQnqKsYmENbuAolg3YT9I8FMuD0DCAjOxyxKDdcNJBm8YSj4fCbYdAanseEw-PS4edHZM8OR8XhZf3r39fPWBHj69_3j15kCdVCzTrgZmu86VsiyF1VZ3oDrL6kaCUo5b4UonG8mBuYa3YJ3cV6XkNVTtvgOtysvi9ca7rM0E7flPzBL9ZOPRBOvN35nZD6YPN6bSVc0UQ4IXZ4IYvq6Qspl8cjCOdoawJsN1zbRQXGuEPv8Heh3WiAMnI1iJS8eRKkTxDeVwlSlCd9cMZ-ZkFbNZxaBVzMkqpsaaZ39OcVfxyxsIEBsgYWruIf6W_j_rD67l0Vk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2039704705</pqid></control><display><type>article</type><title>Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Shin, Jung Kyong ; Kim, Hee Cheol ; Lee, Woo Yong ; Yun, Seong Hyeon ; Cho, Yong Beom ; Huh, Jung Wook ; Park, Yoon Ah ; Chun, Ho-Kyung</creator><creatorcontrib>Shin, Jung Kyong ; Kim, Hee Cheol ; Lee, Woo Yong ; Yun, Seong Hyeon ; Cho, Yong Beom ; Huh, Jung Wook ; Park, Yoon Ah ; Chun, Ho-Kyung</creatorcontrib><description>Background
The introduction of complete mesocolic excision (CME) with central vessel ligation (CVL) for right-sided colon cancer has improved oncologic outcomes. However, there is controversy over the oncologic safety of laparoscopic CME with CVL. This study compared short-term and long-term oncologic outcomes between laparoscopic and open modified CME (mCME) with CVL in patients with right-sided colon cancer.
Methods
We enrolled 1239 patients who underwent open mCME with CVL and 1010 patients treated by a laparoscopic approach for right-side colon cancer between 2000 and 2013 and used 1:1 propensity score matching to adjust for potential baseline confounders between two groups.
Results
After propensity score matching, 683 patients who underwent open mCME with CVL were compared with 683 patients treated with a laparoscopic approach. There were no significant differences between these groups in age, sex, ASA score, TNM stage, tumor size, lymphovascular invasion, and perineural invasion. Comparison of open and laparoscopic mCME groups showed no significant difference in postoperative morbidity (21.4 vs. 18.3%,
p
= 0.175) and mortality (0.1 vs. 0%,
p
= 1.000). The laparoscopic mCME group showed shorter length of hospital stay. The 5-year overall survival rate was 83.7% in the open group and 94.7% in the laparoscopic group (
p
< 0.001). The laparoscopic group also showed a significantly better 5-year disease-free survival rate (82.7 vs. 88.7%,
p
= 0.009) and 5-year disease-specific survival rate (83.7 vs. 94.7%,
p
< 0.001).
Conclusion
Laparoscopic modified mesocolic excision with central vascular ligation is a safe and feasible approach with better short-term recovery profiles and potential oncologic benefits than the open approach for right-sided colon cancer.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-017-5970-6</identifier><identifier>PMID: 29101572</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Colorectal cancer ; Gastroenterology ; Gynecology ; Hepatology ; Laparoscopy ; Medicine ; Medicine & Public Health ; Proctology ; Surgery</subject><ispartof>Surgical endoscopy, 2018-06, Vol.32 (6), p.2721-2731</ispartof><rights>The Author(s) 2017</rights><rights>Surgical Endoscopy is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-f6e0affc34332a9a9fe7fa06b4e77c1a2c3c4b41e0cb1deac4853416e5d8fe973</citedby><cites>FETCH-LOGICAL-c470t-f6e0affc34332a9a9fe7fa06b4e77c1a2c3c4b41e0cb1deac4853416e5d8fe973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-017-5970-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-017-5970-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29101572$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shin, Jung Kyong</creatorcontrib><creatorcontrib>Kim, Hee Cheol</creatorcontrib><creatorcontrib>Lee, Woo Yong</creatorcontrib><creatorcontrib>Yun, Seong Hyeon</creatorcontrib><creatorcontrib>Cho, Yong Beom</creatorcontrib><creatorcontrib>Huh, Jung Wook</creatorcontrib><creatorcontrib>Park, Yoon Ah</creatorcontrib><creatorcontrib>Chun, Ho-Kyung</creatorcontrib><title>Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
The introduction of complete mesocolic excision (CME) with central vessel ligation (CVL) for right-sided colon cancer has improved oncologic outcomes. However, there is controversy over the oncologic safety of laparoscopic CME with CVL. This study compared short-term and long-term oncologic outcomes between laparoscopic and open modified CME (mCME) with CVL in patients with right-sided colon cancer.
Methods
We enrolled 1239 patients who underwent open mCME with CVL and 1010 patients treated by a laparoscopic approach for right-side colon cancer between 2000 and 2013 and used 1:1 propensity score matching to adjust for potential baseline confounders between two groups.
Results
After propensity score matching, 683 patients who underwent open mCME with CVL were compared with 683 patients treated with a laparoscopic approach. There were no significant differences between these groups in age, sex, ASA score, TNM stage, tumor size, lymphovascular invasion, and perineural invasion. Comparison of open and laparoscopic mCME groups showed no significant difference in postoperative morbidity (21.4 vs. 18.3%,
p
= 0.175) and mortality (0.1 vs. 0%,
p
= 1.000). The laparoscopic mCME group showed shorter length of hospital stay. The 5-year overall survival rate was 83.7% in the open group and 94.7% in the laparoscopic group (
p
< 0.001). The laparoscopic group also showed a significantly better 5-year disease-free survival rate (82.7 vs. 88.7%,
p
= 0.009) and 5-year disease-specific survival rate (83.7 vs. 94.7%,
p
< 0.001).
Conclusion
Laparoscopic modified mesocolic excision with central vascular ligation is a safe and feasible approach with better short-term recovery profiles and potential oncologic benefits than the open approach for right-sided colon cancer.</description><subject>Abdominal Surgery</subject><subject>Colorectal cancer</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Proctology</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp1UsuO1DAQjBCIHRY-gAuyxIWLwXaceHxBQite0khc4Gw5TifxKomD7ewy38hP0UOG5SFxst1dXdXtrqJ4ytlLzph6lRiTtaSMK1ppxWh9r9hxWQoqBN_fL3ZMl4wKpeVF8Sila4ZwzauHxYXQnPFKiV3x_WAXG0NyYfGOTKH1nYeWTJCCCyOG4JvzyYeZ3Po8EAdzjnYkNza5dbSRjL63-ZT2M4m-HzJNvkUCLMags7ODSNIQbhNpIOftETMldm4JQnqKsYmENbuAolg3YT9I8FMuD0DCAjOxyxKDdcNJBm8YSj4fCbYdAanseEw-PS4edHZM8OR8XhZf3r39fPWBHj69_3j15kCdVCzTrgZmu86VsiyF1VZ3oDrL6kaCUo5b4UonG8mBuYa3YJ3cV6XkNVTtvgOtysvi9ca7rM0E7flPzBL9ZOPRBOvN35nZD6YPN6bSVc0UQ4IXZ4IYvq6Qspl8cjCOdoawJsN1zbRQXGuEPv8Heh3WiAMnI1iJS8eRKkTxDeVwlSlCd9cMZ-ZkFbNZxaBVzMkqpsaaZ39OcVfxyxsIEBsgYWruIf6W_j_rD67l0Vk</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Shin, Jung Kyong</creator><creator>Kim, Hee Cheol</creator><creator>Lee, Woo Yong</creator><creator>Yun, Seong Hyeon</creator><creator>Cho, Yong Beom</creator><creator>Huh, Jung Wook</creator><creator>Park, Yoon Ah</creator><creator>Chun, Ho-Kyung</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180601</creationdate><title>Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis</title><author>Shin, Jung Kyong ; Kim, Hee Cheol ; Lee, Woo Yong ; Yun, Seong Hyeon ; Cho, Yong Beom ; Huh, Jung Wook ; Park, Yoon Ah ; Chun, Ho-Kyung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-f6e0affc34332a9a9fe7fa06b4e77c1a2c3c4b41e0cb1deac4853416e5d8fe973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Colorectal cancer</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Proctology</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shin, Jung Kyong</creatorcontrib><creatorcontrib>Kim, Hee Cheol</creatorcontrib><creatorcontrib>Lee, Woo Yong</creatorcontrib><creatorcontrib>Yun, Seong Hyeon</creatorcontrib><creatorcontrib>Cho, Yong Beom</creatorcontrib><creatorcontrib>Huh, Jung Wook</creatorcontrib><creatorcontrib>Park, Yoon Ah</creatorcontrib><creatorcontrib>Chun, Ho-Kyung</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shin, Jung Kyong</au><au>Kim, Hee Cheol</au><au>Lee, Woo Yong</au><au>Yun, Seong Hyeon</au><au>Cho, Yong Beom</au><au>Huh, Jung Wook</au><au>Park, Yoon Ah</au><au>Chun, Ho-Kyung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>32</volume><issue>6</issue><spage>2721</spage><epage>2731</epage><pages>2721-2731</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
The introduction of complete mesocolic excision (CME) with central vessel ligation (CVL) for right-sided colon cancer has improved oncologic outcomes. However, there is controversy over the oncologic safety of laparoscopic CME with CVL. This study compared short-term and long-term oncologic outcomes between laparoscopic and open modified CME (mCME) with CVL in patients with right-sided colon cancer.
Methods
We enrolled 1239 patients who underwent open mCME with CVL and 1010 patients treated by a laparoscopic approach for right-side colon cancer between 2000 and 2013 and used 1:1 propensity score matching to adjust for potential baseline confounders between two groups.
Results
After propensity score matching, 683 patients who underwent open mCME with CVL were compared with 683 patients treated with a laparoscopic approach. There were no significant differences between these groups in age, sex, ASA score, TNM stage, tumor size, lymphovascular invasion, and perineural invasion. Comparison of open and laparoscopic mCME groups showed no significant difference in postoperative morbidity (21.4 vs. 18.3%,
p
= 0.175) and mortality (0.1 vs. 0%,
p
= 1.000). The laparoscopic mCME group showed shorter length of hospital stay. The 5-year overall survival rate was 83.7% in the open group and 94.7% in the laparoscopic group (
p
< 0.001). The laparoscopic group also showed a significantly better 5-year disease-free survival rate (82.7 vs. 88.7%,
p
= 0.009) and 5-year disease-specific survival rate (83.7 vs. 94.7%,
p
< 0.001).
Conclusion
Laparoscopic modified mesocolic excision with central vascular ligation is a safe and feasible approach with better short-term recovery profiles and potential oncologic benefits than the open approach for right-sided colon cancer.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29101572</pmid><doi>10.1007/s00464-017-5970-6</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Surgical endoscopy, 2018-06, Vol.32 (6), p.2721-2731 |
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| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Colorectal cancer Gastroenterology Gynecology Hepatology Laparoscopy Medicine Medicine & Public Health Proctology Surgery |
| title | Laparoscopic modified mesocolic excision with central vascular ligation in right-sided colon cancer shows better short- and long-term outcomes compared with the open approach in propensity score analysis |
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