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Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery,Surgical technique
Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim, On behalf of The Korean Laparoscopic Colorectal Surgery Study Group
Ann Coloproctol. 2021;37(6):434-444.   Published online December 8, 2021
DOI: https://doi.org/10.3393/ac.2021.00955.0136
  • 5,533 View
  • 276 Download
  • 18 Web of Science
  • 22 Citations
AbstractAbstract PDF
Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

Citations

Citations to this article as recorded by  
  • Laparoscopic right hemicolectomy: a SICE (Società Italiana di Chirurgia Endoscopica e Nuove tecnologie) network prospective study on the approach to right colon lymphadenectomy in Italy: is there a standard?—CoDIG 2 (ColonDx Italian Group)
    G. Anania, M. Chiozza, A. Campagnaro, F. Bagolini, G. Resta, D. Azzolina, G. Silecchia, R. Cirocchi, A. Agrusa, D. Cuccurullo, M. Guerrieri, V. Adamo, M. Ammendola, P. Angelini, M. Annecchiarico, G. Aprea, F. Autori, G. Baldazzi, A. Balla, G. Baronio, G.
    Surgical Endoscopy.2024; 38(3): 1432.     CrossRef
  • Retrocaecal, supracolic and medial dissection (the RESUME approach) as an optimal surgical procedure for right‐sided colon cancer—A Video Vignette
    Hong‐min Ahn, Min Hyeong Jo, Mi Jeong Choi, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
    Colorectal Disease.2024; 26(7): 1480.     CrossRef
  • Surgical treatment of right colon cancer
    A. A. Nevolskikh, V. A. Avdeenko, I. P. Reznik, T. P. Pochuev, R. F. Zibirov, S. A. Ivanov, A. D. Kaprin
    Siberian journal of oncology.2024; 23(3): 133.     CrossRef
  • Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer
    Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha
    Cancers.2024; 16(20): 3496.     CrossRef
  • Robotic-Assisted Laparoscopic Complete Mesocolic Excision
    Inci Sahin, Bilgi Baca
    Digestive Disease Interventions.2023; 07(01): 024.     CrossRef
  • A comparison of the efficacy and safety of natural orifice specimen extraction and conventional laparoscopic surgery in patients with sigmoid colon/high rectal cancer
    Qiang He, Jing Huang, Liyun Niu, Chunbao Zhai
    Journal of Surgical Oncology.2023; 127(7): 1160.     CrossRef
  • Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
    Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
    Annals of Surgical Treatment and Research.2023; 104(3): 156.     CrossRef
  • Surgical and oncological outcomes of laparoscopic right hemicolectomy (D3 + CME) for colon cancer: A prospective single-center cohort study
    Xiaolin Wu, Yixin Tong, Daxing Xie, Haijie Li, Jie Shen, Jianping Gong
    Surgical Endoscopy.2023; 37(8): 6107.     CrossRef
  • Incidence and survival of adenocarcinoma with mixed subtypes in patients with colorectal cancer
    Fan Zhang, Boqi Xu, Yao Peng, Zhongqi Mao, Shan Tong
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
    Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
    Cancers.2023; 15(20): 4927.     CrossRef
  • Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis
    Elvina C Lingas
    Cureus.2023;[Epub]     CrossRef
  • Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
    Ji-Hyun Seo, In-Ja Park
    Cancers.2023; 15(21): 5211.     CrossRef
  • Ausmaß und Technik der chirurgischen Resektion beim Kolonkarzinom
    Christoph Holmer
    coloproctology.2022; 44(3): 149.     CrossRef
  • Letter to the Editor Reply: ‘Mesocolon Excision in Right Colon Cancer: Is it a Real Oncological Procedure or a Mere Surgical Act?’
    Tamara Díaz Vico, Luis Joaquín García Flórez
    Annals of Surgical Oncology.2022; 29(9): 5855.     CrossRef
  • Medical disease and ambulatory surgery, new insights in patient selection based on medical disease
    Thomas Fuchs-Buder, Jacob Rosenberg
    Current Opinion in Anaesthesiology.2022; 35(3): 385.     CrossRef
  • Is the oncological impact of vascular invasion more important in right colon cancer?
    Gyung Mo Son
    Journal of Minimally Invasive Surgery.2022; 25(2): 49.     CrossRef
  • Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy
    Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park
    Journal of Minimally Invasive Surgery.2022; 25(3): 116.     CrossRef
  • Multidisciplinary treatment strategy for early colon cancer
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Korean Medical Association.2022; 65(9): 558.     CrossRef
  • Direction of diagnosis and treatment improvement in colorectal cancer
    In Ja Park
    Journal of the Korean Medical Association.2022; 65(9): 540.     CrossRef
  • Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 203.     CrossRef
  • Robot-Assisted Colorectal Surgery
    Young Il Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
    In Ja Park
    Annals of Coloproctology.2021; 37(6): 349.     CrossRef
Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer
Gyung Mo Son, Bong-Hyeon Kye, Min Ki Kim, Jun-Gi Kim
Ann Coloproctol. 2019;35(5):229-237.   Published online October 31, 2019
DOI: https://doi.org/10.3393/ac.2019.10.16
  • 4,197 View
  • 116 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDF
The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.

Citations

Citations to this article as recorded by  
  • Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea
    Hugo Cuellar-Gomez, Siti Mayuha Rusli, María Esther Ocharan-Hernández, Tae-Hoon Lee, Guglielmo Niccolò Piozzi, Seon-Hahn Kim, Cruz Vargas-De-León, Yazhou He
    Journal of Oncology.2022; 2022: 1.     CrossRef
  • Evidenz in der minimal-invasiven onkologischen Chirurgie des Kolons und des Rektums
    Carolin Kastner, Joachim Reibetanz, Christoph-Thomas Germer, Armin Wiegering
    Der Chirurg.2021; 92(4): 334.     CrossRef
  • The Safety and Feasibility of Laparoscopic Surgery for Very Low Rectal Cancer: A Retrospective Analysis Based on a Single Center’s Experience
    Hyuk-Jun Chung, Jun-Gi Kim, Hyung-Jin Kim, Hyeon-Min Cho, Bong-Hyeon Kye
    Biomedicines.2021; 9(11): 1720.     CrossRef
  • Reoperative laparoscopic rectal surgery: Another potential tool for the expert’s toolbox
    Marc D. Basson
    The American Journal of Surgery.2020; 219(6): 894.     CrossRef
Original Articles
Niti CAR 27 Versus a Conventional End-to-End Anastomosis Stapler in a Laparoscopic Anterior Resection for Sigmoid Colon Cancer
Seung-Jin Kwag, Jun-Gi Kim, Won-Kyung Kang, Jin-Kwon Lee, Seong-Taek Oh
Ann Coloproctol. 2014;30(2):77-82.   Published online April 25, 2014
DOI: https://doi.org/10.3393/ac.2014.30.2.77
  • 3,802 View
  • 31 Download
  • 6 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose

The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer.

Methods

In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded.

Results

There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation.

Conclusion

Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler.

Citations

Citations to this article as recorded by  
  • New alternative colorectal anastomotic devices: A systematic review and meta-analysis
    T. Shakir, T. Pampiglione, M. Hassouna, P. Rogers, J. Dourado, S. Emile, R. Kokelaar, S. Wexner
    The American Journal of Surgery.2025; 240: 116128.     CrossRef
  • Systematic Review and Meta-Analysis on Colorectal Anastomotic Techniques
    Jana Steger, Alissa Jell, Stefanie Ficht, Daniel Ostler, Markus Eblenkamp, Petra Mela, Dirk Wilhelm
    Therapeutics and Clinical Risk Management.2022; Volume 18: 523.     CrossRef
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    R. Tabola, R. Cirocchi, A. Fingerhut, A. Arezzo, J. Randolph, V. Grassi, G. A. Binda, V. D’Andrea, I. Abraha, G. Popivanov, S. Di Saverio, A. Zbar
    Techniques in Coloproctology.2017; 21(3): 177.     CrossRef
  • Can a nickel–titanium memory-shape device serve as a substitute for the stapler in gastrointestinal anastomosis? A systematic review and meta-analysis
    Ning-Ning Li, Wen-Tao Zhao, Xiao-Ting Wu
    Journal of Surgical Research.2016; 201(1): 82.     CrossRef
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    Zhenhai Lu, Jianhong Peng, Cong Li, Fulong Wang, Wu Jiang, Wenhua Fan, Junzhong Lin, Xiaojun Wu, Desen Wan, Zhizhong Pan
    Clinics.2016; 71(5): 264.     CrossRef
  • The New Stapler Device Is Good, But Needs More Evaluation
    Young Wan Kim, Ik Yong Kim
    Annals of Coloproctology.2014; 30(2): 59.     CrossRef
Delorme's Procedure for Complete Rectal Prolapse: Does It Still Have It's Own Role?
Sooho Lee, Bong-Hyeon Kye, Hyung-Jin Kim, Hyeon-Min Cho, Jun-Gi Kim
J Korean Soc Coloproctol. 2012;28(1):13-18.   Published online February 29, 2012
DOI: https://doi.org/10.3393/jksc.2012.28.1.13
  • 10,113 View
  • 38 Download
  • 8 Citations
AbstractAbstract PDF
Purpose

Although there are more than a hundred techniques, including the transabdominal and the perineal approaches, for the repair of the rectal prolapsed, none of them is perfect. The best repair should be chosen not only to correct the prolapse but also to restore defecatory function and to improve fecal incontinence throughout the patient's lifetime. The aim of this retrospective review is to evaluate clinical outcomes of the Delorme's procedure for the management of the complete rectal prolapse.

Methods

A total of 19 patients (13 females and 6 males) with complete rectal prolapses were treated by using the Delorme's procedure in St. Vincent's Hospital, The Catholic University of Korea, from February 1997 to February 2007. Postoperative anal incontinence was evaluated using the Cleveland Clinic Incontinence Score.

Results

All 19 patients had incontinence to liquid stool, solid stool, and/or flatus preoperatively. Three (15.8%) patients reported recurrence of the rectal prolapse (at 6, 18, 29 months, respectively, after the operation). Information on postoperative incontinence was available for 16 of the 19 patients. Twelve of the 16 patients (75%) reported improved continence (5 [31.3%] were improved and 7 [43.7%] completely recovered from incontinence) while 4 patients had unchanged incontinence symptoms. One (6.3%) patient who did not have constipation preoperatively developed constipation after the operation.

Conclusion

The Delorme's procedure is associated with a marked improvement in anal continence, relatively low recurrence rates, and low incidence of postoperative constipation. This allows us to conclude that this procedure still has its own role in selected patients.

Citations

Citations to this article as recorded by  
  • Transanal rectopexy for external rectal prolapse
    Shantikumar Dhondiram Chivate, Meghana Vinay Chougule, Rahul Shantikumar Chivate, Palak Harshuk Thakrar
    Annals of Coloproctology.2022; 38(6): 415.     CrossRef
  • Epidemiological trends in surgery for rectal prolapse in England 2001–2012: an adult hospital population‐based study
    Y. El‐Dhuwaib, A. Pandyan, C. H. Knowles
    Colorectal Disease.2020; 22(10): 1359.     CrossRef
  • Surgical Treatment of Rectal Prolapse in the Laparoscopic Era; A Review of the Literature
    Akira Tsunoda
    Journal of the Anus, Rectum and Colon.2020; 4(3): 89.     CrossRef
  • Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study
    S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
    Colorectal Disease.2017; 19(1): 50.     CrossRef
  • Perineal resectional procedures for the treatment of complete rectal prolapse: A systematic review of the literature
    Sameh Hany Emile, Hossam Elfeki, Mostafa Shalaby, Ahmad Sakr, Pierpaolo Sileri, Steven D. Wexner
    International Journal of Surgery.2017; 46: 146.     CrossRef
  • Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term
    Carlos Placer, Jose M. Enriquez-Navascués, Ander Timoteo, Garazi Elorza, Nerea Borda, Lander Gallego, Yolanda Saralegui
    Surgery Research and Practice.2015; 2015: 1.     CrossRef
  • Surgical treatments for rectal prolapse: how does a perineal approach compare in the laparoscopic era?
    Monica T. Young, Mehraneh D. Jafari, Michael J. Phelan, Michael J. Stamos, Steven Mills, Alessio Pigazzi, Joseph C. Carmichael
    Surgical Endoscopy.2015; 29(3): 607.     CrossRef
  • Simultaneous Delorme's procedure and inter-sphinteric prosthetic implant for the treatment of rectal prolapse and faecal incontinence: Preliminary experience and literature review
    Emanuel Cavazzoni, Emanuele Rosati, Valentina Zavagno, Luigina Graziosi, Annibale Donini
    International Journal of Surgery.2015; 14: 45.     CrossRef
Treatment of Right Colonic Diverticulitis: The Role of Nonoperative Treatment
Ma Ru Kim, Bong-Hyeon Kye, Hyung Jin Kim, Hyeon-Min Cho, Seong Taek Oh, Jun-Gi Kim
J Korean Soc Coloproctol. 2010;26(6):402-406.   Published online December 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.6.402
  • 3,695 View
  • 39 Download
  • 24 Citations
AbstractAbstract PDF
Purpose

The purpose of this study is to evaluate the value of nonoperative treatment for right-sided colonic diverticulitis.

Methods

One hundred fifty-eight patients with right-sided colonic diverticulitis were evaluated. Clinical history, physical and radiologic findings, and treatments were reviewed retrospectively. Also, additional episodes and treatment modalities were checked.

Results

Our patients were classified according to treatment modality; 135 patients (85.4%) underwent conservative treatment, including antibiotics and bowel rest, and 23 patients (14.6%) underwent surgery. The mean follow-up length was 37.3 months, and 17 patients (17.5%) underwent recurrent right-sided colonic diverticulitis. Based on treatment modality, including surgery and antibiotics, no significant differences in the clinical features and the recurrence rates were noted between the two groups.

Conclusion

Conservative management with bowel rest and antibiotics could be considered as a safe and effective option for treating right-sided colonic diverticulitis. This treatment option for right-sided colonic diverticulitis, even if the disease is complicated, may be the treatment of choice.

Citations

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    Techniques in Coloproctology.2024;[Epub]     CrossRef
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    Adi Rov, Anat Ben-Ari, Eyal Barlev, David Pelcman, Sergio Susmalian, Haim Paran
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    Annals of Medicine and Surgery.2022; 81: 104431.     CrossRef
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    Ker-Kan Tan, Jiayi Wong, Richard Sim
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    Yoori Lee, Todd Francone
    Seminars in Colon and Rectal Surgery.2011; 22(3): 180.     CrossRef
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