Jin Hyeong Yong, Ibahim Abulfetouh M, Bae Jung Hoon, Lee Chul Seung, Han Seung Rim, Lee In Kyu, Lee Do Sang, Lee Yoon Suk
Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Department of Surgery, Faculty of Medicine, Assiut University Hospital, Assiut University, Assiut, Egypt.
J Minim Access Surg. 2022 Apr-Jun;18(2):235-240. doi: 10.4103/jmas.JMAS_88_21.
Laparoscopic complete mesocolic excision (CME) with D3 lymph node dissection for the right colon is becoming popular, but still technically challenging. Several articulating laparoscopic instruments had been introduced to reduce technical difficulties; however, those were not practical. This study aimed to report the first clinical experience of using ArtiSential, a new laparoscopic articulating instrument in laparoscopic complete mesocolic with D3 lymph node dissection for right colon cancer.
This was a retrospective, single-institution, consecutive case study. From October 2018 to March 2020, a total of 33 patients underwent laparoscopic right hemicolectomy using ArtiSential, a new articulating instrument. We compared the short-term outcomes of patients who underwent surgery using ArtiSential (AG) to the conventional instrument (CG).
In total, there were 33 cases in AG and 43 cases in CG. There were no significant differences in operation time (141.0 ± 22.5 vs. 156.0 ± 50.6 min, P = 0.09), mean estimated blood loss (46.8 ± 36.2 vs. 100.8 ± 300.6 ml, P = 0.31) and intra-operative and post-operative complications. However, the number of harvested lymph nodes was higher and the length of hospital stay was shorter in AG than in CG (32.6 ± 12.2 vs. 24.6 ± 7.4, P < 0.01 and 3.0 ± 1.2 vs. 4.1 ± 2.2 days, P = 0.01, respectively).
Laparoscopic CME with D3 lymph node dissection for right colon cancer using ArtiSential, the new articulating laparoscopic instrument is safe and technically feasible.
腹腔镜下全结肠系膜切除术(CME)联合右半结肠D3淋巴结清扫术正逐渐普及,但在技术上仍具有挑战性。为降低技术难度,已引入多种可弯曲腹腔镜器械;然而,这些器械并不实用。本研究旨在报告首例使用新型腹腔镜可弯曲器械ArtiSential行腹腔镜下全结肠系膜切除联合右半结肠D3淋巴结清扫术治疗右半结肠癌的临床经验。
这是一项回顾性、单中心、连续病例研究。2018年10月至2020年3月,共有33例患者使用新型可弯曲器械ArtiSential接受了腹腔镜右半结肠切除术。我们将使用ArtiSential(AG组)手术的患者与使用传统器械(CG组)手术的患者的短期结局进行了比较。
AG组共33例,CG组共43例。手术时间(141.0±22.5 vs. 156.0±50.6分钟,P = 0.09)、平均估计失血量(46.8±36.2 vs. 100.8±300.6毫升,P = 0.31)以及术中及术后并发症方面,两组间无显著差异。然而,AG组的淋巴结清扫数量更多,住院时间更短(分别为32.6±12.2 vs. 24.6±7.4,P < 0.01;3.0±1.2 vs. 4.1±2.2天,P = 0.01)。
使用新型腹腔镜可弯曲器械ArtiSential行腹腔镜下右半结肠癌CME联合D3淋巴结清扫术是安全且技术可行的。