The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer?
Abstract Background The greater omentum is derived from the foregut, and the right hemicolon is derived from the midgut based on developmental anatomy. This study aimed to investigate whether the greater omentum should be resected in laparoscopic complete mesocolic excision based on developmental an...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02020-8 |
| _version_ | 1797823017768714240 |
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| author | Kai Li Fengyu Cao Xiaobo He Yongbin Zheng |
| author_facet | Kai Li Fengyu Cao Xiaobo He Yongbin Zheng |
| author_sort | Kai Li |
| collection | DOAJ |
| description | Abstract Background The greater omentum is derived from the foregut, and the right hemicolon is derived from the midgut based on developmental anatomy. This study aimed to investigate whether the greater omentum should be resected in laparoscopic complete mesocolic excision based on developmental anatomy for right-sided colon cancer. Methods A total of 183 consecutive patients with right-sided colon cancer were recruited in this study between February 2020 and July 2022. Ninety-eight patients underwent standard laparoscopic complete mesocolic excision surgery (CME group). The presence of isolated tumor cells and micrometastases was detected in resected greater omentum by the HE staining and immunohistochemistry analysis. Based on developmental anatomy, laparoscopic CME surgery with greater omentum preservation (DACME group) was proposed and performed on 85 right-sided colon cancer patients. To overcome selection bias, we performed a 1:1 match between two groups using four variables: age, sex, BMI, and ASA scores. Results No isolated tumor cells and micrometastases were found in the resected greater omentum specimen in the CME group. After the propensity score, 81 pairs were balanced and analyzed. Patients in the DACME group showed shorter operative time (194.9 ± 16.4 min vs.201.5 ± 11.5 min, p = 0.002), less blood loss (23.5 ± 24.7 ml vs.33.6 ± 26.3 ml, p = 0.013), and the shorter hospital stays (9.6 ± 1.7 days vs.10.3 ± 2.0 days, p = 0.010) compared with patients in the CME group. In addition, patients in the DACME group had a lower incidence of postoperative complications (4.9% vs.14.8%, p = 0.035) than patients in the CME group. Conclusion The greater omentum should be preserved during right-sided colon cancer surgery, laparoscopic CME surgery based on developmental anatomy is technically safe and feasible for right-sided colon cancer. |
| first_indexed | 2024-03-13T10:17:59Z |
| format | Article |
| id | doaj.art-6dc17c045fce43b58bcb8353be72b53a |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-13T10:17:59Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-6dc17c045fce43b58bcb8353be72b53a2023-05-21T11:06:50ZengBMCBMC Surgery1471-24822023-05-012311810.1186/s12893-023-02020-8The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer?Kai Li0Fengyu Cao1Xiaobo He2Yongbin Zheng3Department of Gastrointestinal Surgery, Renmin Hospital of Wuhan UniversityDepartment of Gastrointestinal Surgery, Renmin Hospital of Wuhan UniversityDepartment of Gastrointestinal Surgery, Renmin Hospital of Wuhan UniversityDepartment of Gastrointestinal Surgery, Renmin Hospital of Wuhan UniversityAbstract Background The greater omentum is derived from the foregut, and the right hemicolon is derived from the midgut based on developmental anatomy. This study aimed to investigate whether the greater omentum should be resected in laparoscopic complete mesocolic excision based on developmental anatomy for right-sided colon cancer. Methods A total of 183 consecutive patients with right-sided colon cancer were recruited in this study between February 2020 and July 2022. Ninety-eight patients underwent standard laparoscopic complete mesocolic excision surgery (CME group). The presence of isolated tumor cells and micrometastases was detected in resected greater omentum by the HE staining and immunohistochemistry analysis. Based on developmental anatomy, laparoscopic CME surgery with greater omentum preservation (DACME group) was proposed and performed on 85 right-sided colon cancer patients. To overcome selection bias, we performed a 1:1 match between two groups using four variables: age, sex, BMI, and ASA scores. Results No isolated tumor cells and micrometastases were found in the resected greater omentum specimen in the CME group. After the propensity score, 81 pairs were balanced and analyzed. Patients in the DACME group showed shorter operative time (194.9 ± 16.4 min vs.201.5 ± 11.5 min, p = 0.002), less blood loss (23.5 ± 24.7 ml vs.33.6 ± 26.3 ml, p = 0.013), and the shorter hospital stays (9.6 ± 1.7 days vs.10.3 ± 2.0 days, p = 0.010) compared with patients in the CME group. In addition, patients in the DACME group had a lower incidence of postoperative complications (4.9% vs.14.8%, p = 0.035) than patients in the CME group. Conclusion The greater omentum should be preserved during right-sided colon cancer surgery, laparoscopic CME surgery based on developmental anatomy is technically safe and feasible for right-sided colon cancer.https://doi.org/10.1186/s12893-023-02020-8Developmental anatomyComplete mesocolic excisionRight-sided colon cancerLaparoscopic surgery |
| spellingShingle | Kai Li Fengyu Cao Xiaobo He Yongbin Zheng The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer? BMC Surgery Developmental anatomy Complete mesocolic excision Right-sided colon cancer Laparoscopic surgery |
| title | The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer? |
| title_full | The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer? |
| title_fullStr | The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer? |
| title_full_unstemmed | The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer? |
| title_short | The concept of developmental anatomy: the greater omentum should be resected in right-sided colon cancer? |
| title_sort | concept of developmental anatomy the greater omentum should be resected in right sided colon cancer |
| topic | Developmental anatomy Complete mesocolic excision Right-sided colon cancer Laparoscopic surgery |
| url | https://doi.org/10.1186/s12893-023-02020-8 |
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