Sica Giuseppe S, Anania Gabriele, Fiorani Cristina, Siragusa Leandro, Vinci Danilo, Caricato Marco, Delrio Paolo, Agrusa Antonino, Baldazzi Gianandrea, Reddavid Rossella, Pellino Gianluca
Minimally Invasive and Gastrointestinal Surgery Unit, University of Rome Tor Vergata, Rome, Italy.
Department of Medical Science, University of Ferrara, Ferrara, Italy.
BJS Open. 2025 May 7;9(3). doi: 10.1093/bjsopen/zraf066.
Complete mesocolic excision refers to a radical right hemicolectomy for cancer following embryologically defined anatomical planes. However, heterogeneity in definitions and techniques is a barrier to research. The aim of the Radical Right Colectomy-Surgical Technique Approved Report (RRoC-STAR) collaborative is to provide international expert consensus-based definitions and standardized terminology and surgical steps for right hemicolectomy for locally advanced colon cancer.
Authors of publications reporting on radical right hemicolectomy techniques were invited to complete an ACCORD-compliant Delphi questionnaire (two rounds). A standardized name (for the procedure) and a data sheet for reporting the procedure were proposed, along with 21 items, including terminology and surgical steps. The assembled panel was asked to vote for each item, with consensus considered to have been reached for items that achieved at least 80% agreement.
Of 162 invited authors, 67 completed both Delphi rounds. All but 1 of the 21 items received consensus after 2 rounds. Consensus was reached on the use of the proposed data sheet for reporting, the term radical right colectomy (RRC), and the surgical steps deemed necessary for RRC, namely preservation of mesocolic integrity, sharp dissection of the anterolateral surface of the superior mesenteric vein up to the middle colic vein, ligation at the origin of vessels, and dissection of lymphoadipose tissue around the gastrocolic trunk of Henle.
This study provides an international expert consensus-based definition and standardization of terminology and the surgical steps required to perform RRC. A comprehensive data sheet for reporting RRC is introduced to enable data homogenization from current and future studies.
完整结肠系膜切除术是指按照胚胎学定义的解剖平面进行的结肠癌根治性右半结肠切除术。然而，定义和技术的异质性是研究的一个障碍。根治性右半结肠切除术-手术技术批准报告（RRoC-STAR）协作组的目的是为局部晚期结肠癌的右半结肠切除术提供基于国际专家共识的定义、标准化术语和手术步骤。
邀请报告根治性右半结肠切除术技术的出版物作者完成一份符合ACCORD标准的德尔菲问卷（两轮）。提出了一个标准化名称（用于该手术）和一份报告该手术的数据表，以及21项内容，包括术语和手术步骤。要求 assembled 小组对每个项目进行投票，对于达成至少80%一致意见的项目视为达成共识。
162名受邀作者中，67名完成了两轮德尔菲调查。21项内容中除1项外，其余均在两轮后达成共识。就使用提议的数据表进行报告、根治性右半结肠切除术（RRC）这一术语以及RRC所需的手术步骤达成了共识，即保留结肠系膜完整性、沿肠系膜上静脉前外侧表面锐性解剖至结肠中静脉、在血管起始处结扎以及解剖Henle胃结肠干周围的淋巴脂肪组织。
本研究提供了基于国际专家共识的定义、术语标准化以及进行RRC所需的手术步骤。引入了一份全面的RRC报告数据表，以实现当前和未来研究数据的同质化。
