Clinical Trials Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 528-537
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.528
Analysis of 20 patients with laparoscopic extended right colectomy
Hui-Da Zheng, Jian-Hua Xu, Yu-Rong Liu, Ya-Feng Sun
Hui-Da Zheng, Jian-Hua Xu, Yu-Rong Liu, Ya-Feng Sun, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Author contributions: Zheng HD, Xu JH contributed equally to this study and should be regarded as co-first authors; Zheng HD and Xu JH designed the study, collected the data and performed the analysis; Zheng HD, Sun YF and Liu YR wrote the manuscript; Sun YF and Xu JH provided clinical advice, reviewed the manuscript and gave final approval of the version of the article to be published.
Supported by the Malignant Tumor Clinical Medicine Research Center, Quanzhou City, Fujian Province, China, No. 2020N090s.
Institutional review board statement: The Ethics Committee of The Second Affiliated Hospital of Fujian Medical University, No. 2021-258.
Clinical trial registration statement: The data used in the study have been registered at www.Clinicaltrials.gov, No. NCT03936530.
Informed consent statement: All study participants or their legal guardians provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Feng Sun, MD, PhD, Associate Chief Physician, Surgeon, Surgical Oncologist, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian Province, China. syf791006@163.com
Received: June 22, 2021
Peer-review started: June 22, 2021
First decision: September 28, 2021
Revised: September 29, 2021
Accepted: December 10, 2021
Article in press: December 10, 2021
Published online: January 14, 2022
Abstract
BACKGROUND

Currently, the standard surgical procedure for right colon cancer is complete mesocolic excision. Whether preventive extended lymph node dissection for colon cancer located in the hepatic flexure or right transverse colon should be performed remains controversial because the safety and effectiveness of the operation have not been proven, and infrapyloric lymph nodes (No. 206) and lymph nodes in the greater curvature of the stomach (No. 204) have not been strictly defined and distinguished as surgical indicators in previous studies.

AIM

To analyze the metastatic status of infrapyloric lymph nodes and lymph nodes of the greater curvature of the stomach and perioperative complications and systematically evaluate the feasibility and safety of laparoscopic extended right colectomy using prospective data collected retrospectively.

METHODS

The study was a clinical study. Twenty patients with colon cancer who underwent laparoscopic extended right colon resection in our hospital from June 2020 to May 2021 were included.

RESULTS

Among the patients who underwent extended right colon resection, there were no intraoperative complications or conversion to laparotomy; 2 patients had gastrocolic ligament lymph node metastasis, and 5 patients had postoperative complications. The patients with postoperative complications received conservative treatment.

CONCLUSION

Laparoscopic extended right colon resection is safe. However, malignant tumors located in the liver flexure or the right-side transverse colon are more likely to metastasize to the gastrocolic ligament lymph nodes, and notably, the incidence of gastroparesis was high. The number of patients was small, and the follow-up time was short. It is necessary to further increase the sample size to evaluate the No. 204 and No. 206 lymph node metastasis rates and the long-term survival impact.

Keywords: Laparoscopic extended right colectomy, Infrapyloric lymph nodes, Greater curvature of stomach lymph nodes, Gastroepiploic lymph nodes, Gastroparesis

Core Tip: Whether laparoscopic extended right colectomy should be performed in patients with malignant tumors located in the hepatic flexure and right-side transverse colon remains controversial mainly because of the lack of an understanding of lymph node metastasis in the gastrocolic ligament and doubts regarding the safety of the operation. No prospective studies assessed the possibility and safety of laparoscopic extended right colon resection. Although the sample size in this article was small, the cases were strictly screened and had a certain degree of representativeness, which can provide some insight to surgeons.