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Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience
BACKGROUND: Complete mesocolic excision (CME) for right colon cancers has traditionally been an open procedure. Surgical adoption of minimal access CME remains limited due to the technical challenges, training gaps and lack of level-1 data for proven benefits. Currently there is limited published da...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599208/ https://www.ncbi.nlm.nih.gov/pubmed/33399993 http://dx.doi.org/10.1007/s00464-020-08194-z |
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author | Siddiqi, Najaf Stefan, Samuel Jootun, Ravish Mykoniatis, Ioannis Flashman, Karen Beable, Richard David, Gerald Khan, Jim |
author_facet | Siddiqi, Najaf Stefan, Samuel Jootun, Ravish Mykoniatis, Ioannis Flashman, Karen Beable, Richard David, Gerald Khan, Jim |
author_sort | Siddiqi, Najaf |
collection | PubMed |
description | BACKGROUND: Complete mesocolic excision (CME) for right colon cancers has traditionally been an open procedure. Surgical adoption of minimal access CME remains limited due to the technical challenges, training gaps and lack of level-1 data for proven benefits. Currently there is limited published data regarding the clinical results with the use of robotic CME surgery. Aim To report our experience, results and techniques, highlighting a clinical and oncological results and midterm oncological outcomes for robotic CME. AIM: To report our experience, results and techniques, highlighting a clinical and oncological results and midterm oncological outcomes for robotic CME. METHODS: All patients undergoing standardised robotic CME technique with SMV first approach between January 2015 and September 2019 were included in this retrospective review of a prospectively collected database. Patient demographics, operative data and clinical and oncological outcomes were recorded. RESULTS: Seventy-seven robotic CME resections for right colonic cancers were performed over a 4-year period. Median operative time was 180 (128–454) min and perioperative blood loss was 10 (10–50) ml. There were 25 patients who had previous abdominal surgery. Median postoperative hospital stay was 5 (3–18) days. There was no conversion to open surgery in this series. Median lymph node count was 30 (10–60). Three (4%) patients had R1 resection. There was one (1%) local recurrence in stage III disease and 4(5%) distal recurrence in stage II and stage III. There was no 30- or 90-day mortality. Three-year disease-free survival was 100%, 91.7% and 92% for stages I, II and III, respectively. Overall survival was 94%. CONCLUSIONS: Robotic CME is feasible, effective and safe. Good oncological results and improved survival are seen in this cohort of patients with a standardised approach to robotic CME. |
format | Online Article Text |
id | pubmed-8599208 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-85992082021-11-24 Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience Siddiqi, Najaf Stefan, Samuel Jootun, Ravish Mykoniatis, Ioannis Flashman, Karen Beable, Richard David, Gerald Khan, Jim Surg Endosc Article BACKGROUND: Complete mesocolic excision (CME) for right colon cancers has traditionally been an open procedure. Surgical adoption of minimal access CME remains limited due to the technical challenges, training gaps and lack of level-1 data for proven benefits. Currently there is limited published data regarding the clinical results with the use of robotic CME surgery. Aim To report our experience, results and techniques, highlighting a clinical and oncological results and midterm oncological outcomes for robotic CME. AIM: To report our experience, results and techniques, highlighting a clinical and oncological results and midterm oncological outcomes for robotic CME. METHODS: All patients undergoing standardised robotic CME technique with SMV first approach between January 2015 and September 2019 were included in this retrospective review of a prospectively collected database. Patient demographics, operative data and clinical and oncological outcomes were recorded. RESULTS: Seventy-seven robotic CME resections for right colonic cancers were performed over a 4-year period. Median operative time was 180 (128–454) min and perioperative blood loss was 10 (10–50) ml. There were 25 patients who had previous abdominal surgery. Median postoperative hospital stay was 5 (3–18) days. There was no conversion to open surgery in this series. Median lymph node count was 30 (10–60). Three (4%) patients had R1 resection. There was one (1%) local recurrence in stage III disease and 4(5%) distal recurrence in stage II and stage III. There was no 30- or 90-day mortality. Three-year disease-free survival was 100%, 91.7% and 92% for stages I, II and III, respectively. Overall survival was 94%. CONCLUSIONS: Robotic CME is feasible, effective and safe. Good oncological results and improved survival are seen in this cohort of patients with a standardised approach to robotic CME. Springer US 2021-01-05 2021 /pmc/articles/PMC8599208/ /pubmed/33399993 http://dx.doi.org/10.1007/s00464-020-08194-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Siddiqi, Najaf Stefan, Samuel Jootun, Ravish Mykoniatis, Ioannis Flashman, Karen Beable, Richard David, Gerald Khan, Jim Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
title | Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
title_full | Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
title_fullStr | Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
title_full_unstemmed | Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
title_short | Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
title_sort | robotic complete mesocolic excision (cme) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599208/ https://www.ncbi.nlm.nih.gov/pubmed/33399993 http://dx.doi.org/10.1007/s00464-020-08194-z |
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