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18.04.2018 | original article | Ausgabe 4/2018

European Surgery 4/2018

Impact of anatomical versus non-anatomical resection for stage II and III colon cancer

Zeitschrift:
European Surgery > Ausgabe 4/2018
Autoren:
M.D. Tomoya Funada, M.D. Shintaro Yamazaki, M.D. Mitsugu Kochi, M.D Tadatoshi Takayama

Summary

Background

Segmental non-anatomical colectomy is a current proposed minimally invasive but non-anatomical procedure. However, few studies have compared its efficacy to that of anatomical colectomy.

Objective

To evaluate the prognostic impact of anatomical vs. non-anatomical colectomy in colon cancer.

Patients

Based on the data of 1152 patients who underwent colorectal surgery, the 300 patients with pathologically proven stage II and III colon cancer were included. Patients were divided into two groups, depending on whether the anatomical colectomy (n = 161) or segmental non-anatomical colectomy (n = 139) was performed. The operative procedure was decided by preoperative imaging by taking into account the dominant vessels of the primary tumor. The overall survival and disease-free survival were analyzed.

Results

The number of harvested lymph nodes was significantly larger (p < 0.01) and the metastatic lymph node ratio was significantly lower (p < 0.01) for anatomical colectomy. Mean operation time (p = 0.13), intraoperative blood loss (p = 0.11), and complication (p = 0.70) rates did not differ significantly. The overall survival rates (89.1% vs. 76.9%, p < 0.01) and the 5‑year disease-free survival (86.2% vs. 70.5%, p < 0.01) were significantly better in the anatomical colectomy group than those in the non-anatomical group. The operative procedure (anatomical vs. non-anatomical, odds ratio: 2.65, 95% confidence interval: 1.37–5.35, p < 0.01) was the strongest predictor for overall survival.

Conclusions

Anatomical colectomy has a better prognostic impact than segmental non-anatomical colectomy in stage II and III colon cancer.

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