Laparoscopic Versus Open Right Colectomy for Right Colon Cancer
Colon Cancer
About this trial
This is an interventional treatment trial for Colon Cancer focused on measuring colon, cancer, open, laparoscopic, colectomy, right, mesocolic, excision
Eligibility Criteria
Inclusion Criteria: Histologically confirmed right colon cancer (cecum, ascending colon, hepatic flexure) Surgical resection based on the CME principles Patient 18 to 90 years old American Society of Anesthesiologists score ≤III Τ≤3 Elective operation Signed informed consent of the patient Exclusion Criteria: Non elective operation (hemorrhage, perforation, obstruction) Locally advanced disease (T4) Distant metastases (Stage IV) American Society of Anesthesiologists ≥IV Previous laparotomy BMI >35 kg/m2 Active sepsis or systemic infection Untreated physical and mental disability Pregnancy or breast-feeding Lack of compliance with the protocol process Non-granting of signed informed consent
Sites / Locations
- Department of Surgery, University Hospital of LarissaRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Laparoscopic right colectomy
Open right colectomy
In laparoscopic right colectomy subgroup, the patient will be placed in a lithotomy position. Entrance in the peritoneal cavity will be completed via the open Hasson method. Overall, 4 ports will be used: 10mm at the umbilicus for optical entry, 12mm in the left midclavicular line below the umbilicus as the main working port, 5mm at the McBurney point, and 5mm between the umbilicus and the xiphoid process. Dissection of the peritoneal fold, under the terminal ileum, will be performed based on the medial to lateral approach. Similar to the open approach, the ileocolic vessels, as well as the right branches of the middle colic will be ligated at their origin for cecal and proximal ascending tumors. For hepatic flexure cancers, the medial colic vessels will be ligated. The ileocolic anastomosis will be completed either intracorporeally or extracorporeally, using staples or sutures.
In the open right colectomy group, the operation will start with a midline incision and dissection based on the lateral to medial approach. The lateral peritoneal fold along Toldt's line will be incised and the ascending colon will be mobilized from the retroperitoneum according to the embryological dissection planes. Dissection will continue until the anterior surface of the superior mesenteric vessels at the third duodenal part. Ileocolic and right colic vessels will be ligated at their origins. For hepatic flexure tumors, the middle colic vessels will be also ligated at their origin. The ileocolic anastomosis will be performed using an automatic stapler. The anastomosis will be completed either with staples or sutures.