Key issues in laparoscopic surgery for right-sided colon cancer and the experience of Peking Union Medical College Hospital_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Junyang ,  XIAO Yi

Division of Colorectal Surgery, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, P. R. China;

Corresponding?author：

XIAO Yi, Email: xiaoy@pumch.cn

Keywords：

colonic neoplasm; right hemicolectomy; minimally invasive surgery

DOI：

10.7507/1007-9424.202401078

Video：

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The technique of laparoscopic radical right hemicolectomy is becoming mature, but there are still controversies on some key steps, including the extent of lymph node dissection, the scope of bowel resection, the choice of surgical access and anastomosis. The new function-preserving surgery and natural-orifice transluminal endoscopic surgery (NOTES) have further enhanced the minimally invasive nature of surgery. The author’s have reviewed the latest domestic and international literature, combined with the experience of the author’s center, and elaborated on the current focus issues of laparoscopic radical surgery for right-sided colon cancer.

Citation： LU Junyang, XIAO Yi. Key issues in laparoscopic surgery for right-sided colon cancer and the experience of Peking Union Medical College Hospital. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(5): 513-517. doi: 10.7507/1007-9424.202401078 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Turner MC, Becerra D, Sun Z, et al. The side of the primary tumor affects overall survival in colon adenocarcinoma: an analysis of the national cancer database. Tech Coloproctol, 2019, 23(6): 537-544.
3.	Hashiguchi Y, Muro K, Saito Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol, 2020, 25(1): 1-42.
4.	Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and outcome. Colorectal Dis, 2009, 11(4): 354-364, 364-365.
5.	肖毅. 對本刊2021年第1期所刊“右半結腸癌D3淋巴清掃術與完整系膜切除手術的異同”一文的看法. 中華胃腸外科雜志, 2021, 24(3): 2.
6.	Bertelsen CA, Neuenschwander AU, Jansen JE, et al. Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study. Lancet Oncol, 2015, 16(2): 161-168.
7.	Bertelsen CA, Neuenschwander AU, Jansen JE, et al. 5-year outcome after complete mesocolic excision for right-sided colon cancer: a population-based cohort study. Lancet Oncol, 2019, 20(11): 1556-1565.
8.	Bernhoff R, Sj?vall A, Granath F, et al. Oncological outcomes after complete mesocolic excision in right-sided colon cancer: a population-based study. Colorectal Dis, 2021, 23(6): 1404-1413.
9.	West NP, Morris EJ, Rotimi O, et al. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol, 2008, 9(9): 857-865.
10.	Benz SR, Feder IS, Vollmer S, et al. Complete mesocolic excision for right colonic cancer: prospective multicentre study. Br J Surg, 2022, 110(1): 98-105.
11.	Sammour T, Malakorn S, Thampy R, et al. Selective central vascular ligation (D3 lymphadenectomy) in patients undergoing minimally invasive complete mesocolic excision for colon cancer: optimizing the risk-benefit equation. Colorectal Dis, 2020, 22(1): 53-61.
12.	肖毅, 徐徠, 陸君陽. 根治性右半結腸癌淋巴結清掃范圍的探討. 中華外科雜志, 2016, 54(6): 408-412.
13.	Lu JY, Xu L, Xue HD, et al. The radical extent of lymphadenectomy - D2 dissection versus complete mesocolic excision of LAparoscopic Right Colectomy for right-sided colon cancer (RELARC) trial: study protocol for a randomized controlled trial. Trials, 2016, 17(1): 582. doi: 10.1186/s13063-016-1710-9.
14.	Karachun A, Panaiotti L, Chernikovskiy I, et al. Short-term outcomes of a multicentre randomized clinical trial comparing D2 versus D3 lymph node dissection for colonic cancer (COLD trial). Br J Surg, 2020, 107(5): 499-508.
15.	Degiuli M, Solej M, Resendiz Aguilar HA, et al. Complete mesocolic excision in comparison with conventional surgery for right colon cancer: a nationwide multicenter study of the Italian Society of Surgical Oncology colorectal cancer network (CoME-in trial). Study protocol for a randomized controlled trial. Jpn J Clin Oncol, 2022, 52(10): 1232-1241.
16.	Xu L, Su X, He Z, et al. Short-term outcomes of complete mesocolic excision versus D2 dissection in patients undergoing laparoscopic colectomy for right colon cancer (RELARC): a randomised, controlled, phase 3, superiority trial. Lancet Oncol, 2021, 22(3): 391-401.
17.	Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol, 2012, 17(1): 1-29.
18.	Piozzi GN, Rusli SM, Baek SJ, et al. Infrapyloric and gastroepiploic node dissection for hepatic flexure and transverse colon cancer: a systematic review. Eur J Surg Oncol, 2022, 48(4): 718-726.
19.	Yalikun A, Cai Z, Hong HJ, et al. Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study. BMJ Open, 2023, 13(2): e066981.
20.	Kobayashi H, West NP, Takahashi K, et al. Quality of surgery for stage Ⅲ colon cancer: comparison between England, Germany, and Japan. Ann Surg Oncol, 2014, 21 Suppl 3: S398-S404.
21.	West NP, Kobayashi H, Takahashi K, et al. Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol, 2012, 30(15): 1763-1769.
22.	He JJ, Sun FF, Xiao Q, et al. Laparoscopic ileocecal-sparing right hemicolectomy (LISH) for cancers of the hepatic flexure or proximal transverse colon: a video vignette. Tech Coloproctol, 2021, 25(7): 891-892.
23.	張森, 馮波, 馬君俊, 等. “翻頁式”完全中間入路腹腔鏡右半結腸癌完整結腸系膜切除術. 中華消化外科雜志, 2015, 14(12): 1026-1030.
24.	肖毅. 選擇中間入路. 中華胃腸外科雜志, 2016, 19(8): 877-878.
25.	鄭波波, 王楠, 吳濤, 等. 改良中間入路與傳統中間入路在腹腔鏡右半結腸切除術中的比較研究. 中華胃腸外科雜志, 2015, 18(8): 812-816.
26.	孫曦羽, 邱輝忠, 費凱倫, 等. 腹腔鏡右半結腸切除腹腔內與腹腔外吻合術后腹腔感染發生情況的比較. 中華胃腸外科雜志, 2017, 20(8): 891-895.
27.	Sun R, Zhang Y, Feng B, et al. Intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right colectomy: an observational cohort study. World J Surg, 2023, 47(3): 785-795.
28.	Gao J, Gu X, Pang M, et al. Risk factors for anastomotic leak and postoperative morbidity after right hemicolectomy for colon cancer: results from a prospective, multi-centre, snapshot study in China. Br J Surg, 2024, 111(1): znad316. doi: 10.1093/bjs/znad316.
29.	肖毅, 孫振, 孫蕊, 等. 單中心經陰道右半結腸切除術的安全性和可行性分析. 中華胃腸外科雜志, 2023, 26(6): 588-594.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Turner MC, Becerra D, Sun Z, et al. The side of the primary tumor affects overall survival in colon adenocarcinoma: an analysis of the national cancer database. Tech Coloproctol, 2019, 23(6): 537-544.
3. Hashiguchi Y, Muro K, Saito Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol, 2020, 25(1): 1-42.
4. Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and outcome. Colorectal Dis, 2009, 11(4): 354-364, 364-365.
5. 肖毅. 對本刊2021年第1期所刊“右半結腸癌D3淋巴清掃術與完整系膜切除手術的異同”一文的看法. 中華胃腸外科雜志, 2021, 24(3): 2.
6. Bertelsen CA, Neuenschwander AU, Jansen JE, et al. Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study. Lancet Oncol, 2015, 16(2): 161-168.
7. Bertelsen CA, Neuenschwander AU, Jansen JE, et al. 5-year outcome after complete mesocolic excision for right-sided colon cancer: a population-based cohort study. Lancet Oncol, 2019, 20(11): 1556-1565.
8. Bernhoff R, Sj?vall A, Granath F, et al. Oncological outcomes after complete mesocolic excision in right-sided colon cancer: a population-based study. Colorectal Dis, 2021, 23(6): 1404-1413.
9. West NP, Morris EJ, Rotimi O, et al. Pathology grading of colon cancer surgical resection and its association with survival: a retrospective observational study. Lancet Oncol, 2008, 9(9): 857-865.
10. Benz SR, Feder IS, Vollmer S, et al. Complete mesocolic excision for right colonic cancer: prospective multicentre study. Br J Surg, 2022, 110(1): 98-105.
11. Sammour T, Malakorn S, Thampy R, et al. Selective central vascular ligation (D3 lymphadenectomy) in patients undergoing minimally invasive complete mesocolic excision for colon cancer: optimizing the risk-benefit equation. Colorectal Dis, 2020, 22(1): 53-61.
12. 肖毅, 徐徠, 陸君陽. 根治性右半結腸癌淋巴結清掃范圍的探討. 中華外科雜志, 2016, 54(6): 408-412.
13. Lu JY, Xu L, Xue HD, et al. The radical extent of lymphadenectomy - D2 dissection versus complete mesocolic excision of LAparoscopic Right Colectomy for right-sided colon cancer (RELARC) trial: study protocol for a randomized controlled trial. Trials, 2016, 17(1): 582. doi: 10.1186/s13063-016-1710-9.
14. Karachun A, Panaiotti L, Chernikovskiy I, et al. Short-term outcomes of a multicentre randomized clinical trial comparing D2 versus D3 lymph node dissection for colonic cancer (COLD trial). Br J Surg, 2020, 107(5): 499-508.
15. Degiuli M, Solej M, Resendiz Aguilar HA, et al. Complete mesocolic excision in comparison with conventional surgery for right colon cancer: a nationwide multicenter study of the Italian Society of Surgical Oncology colorectal cancer network (CoME-in trial). Study protocol for a randomized controlled trial. Jpn J Clin Oncol, 2022, 52(10): 1232-1241.
16. Xu L, Su X, He Z, et al. Short-term outcomes of complete mesocolic excision versus D2 dissection in patients undergoing laparoscopic colectomy for right colon cancer (RELARC): a randomised, controlled, phase 3, superiority trial. Lancet Oncol, 2021, 22(3): 391-401.
17. Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol, 2012, 17(1): 1-29.
18. Piozzi GN, Rusli SM, Baek SJ, et al. Infrapyloric and gastroepiploic node dissection for hepatic flexure and transverse colon cancer: a systematic review. Eur J Surg Oncol, 2022, 48(4): 718-726.
19. Yalikun A, Cai Z, Hong HJ, et al. Infrapyloric (No. 206) and greater curvature (No. 204) lymph node metastasis in adenocarcinoma located in the right half of the transverse colon (InCLART Study): protocol for a multicentre prospective observational study. BMJ Open, 2023, 13(2): e066981.
20. Kobayashi H, West NP, Takahashi K, et al. Quality of surgery for stage Ⅲ colon cancer: comparison between England, Germany, and Japan. Ann Surg Oncol, 2014, 21 Suppl 3: S398-S404.
21. West NP, Kobayashi H, Takahashi K, et al. Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol, 2012, 30(15): 1763-1769.
22. He JJ, Sun FF, Xiao Q, et al. Laparoscopic ileocecal-sparing right hemicolectomy (LISH) for cancers of the hepatic flexure or proximal transverse colon: a video vignette. Tech Coloproctol, 2021, 25(7): 891-892.
23. 張森, 馮波, 馬君俊, 等. “翻頁式”完全中間入路腹腔鏡右半結腸癌完整結腸系膜切除術. 中華消化外科雜志, 2015, 14(12): 1026-1030.
24. 肖毅. 選擇中間入路. 中華胃腸外科雜志, 2016, 19(8): 877-878.
25. 鄭波波, 王楠, 吳濤, 等. 改良中間入路與傳統中間入路在腹腔鏡右半結腸切除術中的比較研究. 中華胃腸外科雜志, 2015, 18(8): 812-816.
26. 孫曦羽, 邱輝忠, 費凱倫, 等. 腹腔鏡右半結腸切除腹腔內與腹腔外吻合術后腹腔感染發生情況的比較. 中華胃腸外科雜志, 2017, 20(8): 891-895.
27. Sun R, Zhang Y, Feng B, et al. Intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right colectomy: an observational cohort study. World J Surg, 2023, 47(3): 785-795.
28. Gao J, Gu X, Pang M, et al. Risk factors for anastomotic leak and postoperative morbidity after right hemicolectomy for colon cancer: results from a prospective, multi-centre, snapshot study in China. Br J Surg, 2024, 111(1): znad316. doi: 10.1093/bjs/znad316.
29. 肖毅, 孫振, 孫蕊, 等. 單中心經陰道右半結腸切除術的安全性和可行性分析. 中華胃腸外科雜志, 2023, 26(6): 588-594.

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Key issues in laparoscopic surgery for right-sided colon cancer and the experience of Peking Union Medical College Hospital

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