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. 对本刊2021年第1期所刊“右半结肠癌D3淋巴清扫术与完整系膜切除手术的异同”一文的看法. 中华胃肠外科杂志, 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, Sjövall 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, 徐徕, 陆君阳. 根治性右半结肠癌淋巴结清扫范围的探讨. 中华外科杂志, 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.	张森, 冯波, 马君俊, 等. “翻页式”完全中间入路腹腔镜右半结肠癌完整结肠系膜切除术. 中华消化外科杂志, 2015, 14(12): 1026-1030.
24.	肖毅. 选择中间入路. 中华胃肠外科杂志, 2016, 19(8): 877-878.
25.	郑波波, 王楠, 吴涛, 等. 改良中间入路与传统中间入路在腹腔镜右半结肠切除术中的比较研究. 中华胃肠外科杂志, 2015, 18(8): 812-816.
26.	孙曦羽, 邱辉忠, 费凯伦, 等. 腹腔镜右半结肠切除腹腔内与腹腔外吻合术后腹腔感染发生情况的比较. 中华胃肠外科杂志, 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, 孙振, 孙蕊, 等. 单中心经阴道右半结肠切除术的安全性和可行性分析. 中华胃肠外科杂志, 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. 对本刊2021年第1期所刊“右半结肠癌D3淋巴清扫术与完整系膜切除手术的异同”一文的看法. 中华胃肠外科杂志, 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, Sjövall 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, 徐徕, 陆君阳. 根治性右半结肠癌淋巴结清扫范围的探讨. 中华外科杂志, 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. 张森, 冯波, 马君俊, 等. “翻页式”完全中间入路腹腔镜右半结肠癌完整结肠系膜切除术. 中华消化外科杂志, 2015, 14(12): 1026-1030.
24. 肖毅. 选择中间入路. 中华胃肠外科杂志, 2016, 19(8): 877-878.
25. 郑波波, 王楠, 吴涛, 等. 改良中间入路与传统中间入路在腹腔镜右半结肠切除术中的比较研究. 中华胃肠外科杂志, 2015, 18(8): 812-816.
26. 孙曦羽, 邱辉忠, 费凯伦, 等. 腹腔镜右半结肠切除腹腔内与腹腔外吻合术后腹腔感染发生情况的比较. 中华胃肠外科杂志, 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, 孙振, 孙蕊, 等. 单中心经阴道右半结肠切除术的安全性和可行性分析. 中华胃肠外科杂志, 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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