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Date Published: 07/09/2024
Abstract Views: 143
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DOI: https://doi.org/10.51298/vmj.v541i3.10832
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Vol. 541 No. 3 (2024)
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Các bài báo
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Qúach, V. K., Dương, S. T., Phạm, H. H., Nguyễn, X. H., Vũ, Đức T., Tống, Q. H., Trần, M. H., Phạm, Q. T., Phạm, B. A., & Nguyễn, T. T. T. (2024). LAPAROSCOPIC RIGHT HEMICOLECTOMY WITH D3 LYMPHADENECTOMY INDICATIONS, TECHNIQUES AND EARLY RESULTS. Vietnam Medical Journal, 541(3). https://doi.org/10.51298/vmj.v541i3.10832

LAPAROSCOPIC RIGHT HEMICOLECTOMY WITH D3 LYMPHADENECTOMY INDICATIONS, TECHNIQUES AND EARLY RESULTS

Văn Kiên Qúach, Sơn Tùng Dương, Hoàng Hà Phạm, Xuân Hòa Nguyễn, Đức Thịnh Vũ, Quang Hiếu Tống, Minh Hiếu Trần, Quang Thái Phạm, Bá An Phạm, Thị Thanh Tâm Nguyễn

Main Article Content

Abstract

Purpose: Laparoscopic right hemicolectomy with systematic lymphadenectomy is indicated for cancerous lesions in the ascending colon and right part of the transverse colon. The dissection of D3 lymph nodes, which includes paracolic lymph nodes, mesocolic lymph nodes, and corresponding arterial root lymph nodes, poses a challenge due to the complexity of the associated vascular system. The study aimed to evaluate the criteria, technical aspects, and early outcomes after laparoscopic right colectomy with D3 lymph node dissection. Methods: Retrospective descriptive, uncontrolled study of 30 patients diagnosed with cancer of the ascending colon, and hepatic flexure at Viet Duc University Hospital who underwent laparoscopic right colon resection with D3 lymph node dissection. The study period: January 2017 to August 2022. Results: The mean age was 60,07±10,7; 73.3% of patients exhibited digestive disorders, while 23.3% presented with bloody stools. In gastrointestinal endoscopy images, cauliflower were observed in 90% of patients. Computed tomography scans indicated stage T3 and T4a tumors in 93.3% of patients. Specifications: 86.7% patient used only 4 trocars. 100% was ligated from the root of ICV (ileocolic vessels), RCV (Right colonic vessels). 100% was complete mesocolic excision. 93.3% was periumbilical midline incision. 70% used 2 linear staplers. We often made anastomoses between the ileum and the colon by handsewn technique (66.7%). 90% was placed one drainage tube in the right paracolic sulcus. The mean operative time was 183.3 ± 33.1 mins. The conversion rate was 0%. The mean number of days to soft diet was 3.07 ± 1.08 day. The mean possible length of stay was 9.3 ± 2.2 days. Anastomotic leakage was not noted. The distribution of the TNM stage was stage III- IVa in 28 patients (93.2%). The mean number of harvested lymph nodes was 19,8 ± 13,7 (range, 5 to 57), and 33.3% of harvested lympho nodes was metastasis. Conclusion: Laparoscopic right hemicolectomy (LRC) with a principle of D3 lymph node dissection seems to be appropriate in treatment of right-sided colon cancer, especial T3-T4a tumor.

Article Details

Keywords

Laparoscopic right hemicolectomy (LRC), D3 lymphadenectomy, early results.

References

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