S.K. Efetov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
A.A. Zubayraeva
I.M. Sechenov First Moscow State Medical University (Sechenov University)
B.S. Semchenko
I.M. Sechenov First Moscow State Medical University (Sechenov University)
P.D. Panova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
M.V. Volgin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
A.K. Rychkova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Primary retroperitoneal approach for vessel-sparing D3-lymph node dissection in left colonic and rectal cancer resections — the first Russian experience
Journal: Pirogov Russian Journal of Surgery. 2023;(12): 26‑33
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To cite this article:
Efetov SK, Zubayraeva AA, Semchenko BS, Panova PD, Volgin MV, Rychkova AK. Primary retroperitoneal approach for vessel-sparing D3-lymph node dissection in left colonic and rectal cancer resections — the first Russian experience. Pirogov Russian Journal of Surgery.
2023;(12):26‑33. (In Russ., In Engl.)
https://doi.org/10.17116/hirurgia202312126
To develop and describe a technique of primary retroperitoneal approach for vessel-sparing D3-lymph node dissection in the left colon and rectal cancer surgery; to evaluate the short-term results of the first series of patients treated with a new minimally invasive method.
The first 10 patients with adenocarcinoma of the left colon and rectum, who underwent surgical treatment using the retroperitoneal approach with vessel-sparing D3 lymph node dissection, were included in the study. The primary retroperitoneal approach involved mobilization of the left side of the colon, D3 lymph node dissection with skeletonization of inferior mesenteric artery (IMA) and selective ligation of afferent vessels from retroperitoneal space using SILS access system at the first steps of surgery. Intersection of visceral and parietal peritoneum, as well as intersection of mesentery within the bowel resection borders was performed laparoscopically. Surgical specimen was removed through retroperitoneal access incision.
Duration of retroperitoneal stage with lymph node dissection was 100 min (70.0—115.0). There were 28.5 (22—37) regional lymph nodes removed during vessel-sparing D3 lymph node dissection with IMA skeletalization, 3 (1—4) metastatic regional lymph nodes and 3.5 (2—5) apical nodes. In 4 out of 10 patients, we damaged visceral peritoneum during retroperitoneal dissection. Two patients developed Clavien—Dindo grade 1—2 complications. Mean postoperative hospital stay was 8 days (5—12).
We developed retroperitoneal vessel-sparing D3 lymph node dissection for the treatment of left colon and rectal cancer. Initial results demonstrated safety and feasibility of this approach.
Keywords:
Authors:
S.K. Efetov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
A.A. Zubayraeva
I.M. Sechenov First Moscow State Medical University (Sechenov University)
B.S. Semchenko
I.M. Sechenov First Moscow State Medical University (Sechenov University)
P.D. Panova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
M.V. Volgin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
A.K. Rychkova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Received:
05.09.2023
Accepted:
29.09.2023
List of references:
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