Colon Adenocarcinoma, Colorectal Neoplasms, Right-sided Colon Cancer
Conditions
Brief summary
The goal of this observational comparative study is to assess whether laparoscopic complete mesocolic excision with central vascular ligation (L-CME with CVL) provides improved short-term surgical outcomes compared with open complete mesocolic excision with central vascular ligation (O-CME with CVL) in patients with right-sided colon cancer. The primary questions this study aims to answer are: Does laparoscopic CME with CVL reduce blood loss, postoperative complications, and length of hospital stay compared with open CME? Does laparoscopic CME with CVL achieve equivalent surgical specimen quality and short-term oncological outcomes compared to the open approach? Researchers compared laparoscopic versus open right hemicolectomy with CME and CVL in adult patients diagnosed with right colon cancer who were eligible for elective surgical resection. Participants underwent standard preoperative assessment, including clinical evaluation, laboratory testing, imaging studies, colonoscopy, and biopsy confirmation. Surgical treatment consisted of either laparoscopic or open complete mesocolic excision with central vascular ligation, performed according to standardized oncologic surgical principles. Postoperative care followed an enhanced recovery protocol. Primary outcome measures included operative time, intraoperative blood loss, time to first flatus, postoperative complications, and duration of hospital stay. Secondary outcomes included quality of the surgical specimen (lymph node yield, mesocolic integrity, and margin status) and short-term oncologic outcomes, including early recurrence during follow-up.
Interventions
PROCEDUREright hemicolectomy laparoscopic surgery
Laparoscopic right hemicolectomy or extended right hemicolectomy using complete mesocolic excision with central vascular ligation, pneumoperitoneum 12-14 mmHg via umbilical port, diamond-shaped port placement, medial-to-lateral dissection along embryological planes, ligation of ileocolic (and right colic/middle colic branch when indicated) at origin, intra- or extracorporeal stapled ileotransverse anastomosis, specimen extraction through Pfannenstiel or right subcostal incision, standard perioperative care.
PROCEDUREopen rt hemicolectmy
Open right hemicolectomy or extended right hemicolectomy using complete mesocolic excision with central vascular ligation, via midline laparotomy, lateral-to-medial mobilization, ligation of ileocolic (and right colic/middle colic branch when indicated) at origin, extracorporeal ileotransverse anastomosis with hand-sewn sutures, standard perioperative care.
Sponsors
Kafrelsheikh University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Intervention model description
Comparison study
Eligibility
Sex/Gender
ALL
Age
25 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* rt cancer colon
Exclusion criteria
* metastatisis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of Postoperative Hospital Stay | From surgery until discharge (up to 30 days) | Number of days from the date of surgery to the date of hospital discharge. |
| Overall Postoperative Morbidity ( Incidence of postoperative complications) | Up to 30 days after surgery | Occurrence of any postoperative complication, including wound infection, anastomotic leak, abdominal collection, pulmonary infection, urinary tract infection, or deep vein thrombosis, occurring within the early postoperative period. |
| Intraoperative Blood Loss ( Estimated blood loss (milliliters)) | During surgery | Volume of blood lost during surgical resection, measured intraoperatively. |
| Operative Time ( Duration of surgery (minutes)) | During surgery | Time from skin incision to skin closure. |
| Postoperative Recovery of Bowel Function (Time to first passage of flatus (hours)) | Up to 72 hours postoperatively | Time elapsed from completion of surgery to first postoperative flatus, indicating recovery of gastrointestinal motility. |
Countries
Egypt
Contacts
CONTACTMohamed Gohar, assistant lecturer
PRINCIPAL_INVESTIGATORMohamed MM Gohar
Kafr Elsheikh university hospitals
Outcome results
None listed