Right-sided Colon Cancer

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.

The traditional surgical treatment for right-sided colon cancer involves the removal of an important structure, the ileocecal valve, which includes the ileocecal valve. This can lead to problems such as diarrhea and malnutrition in patients. This study reconstructs an artificial ileocecal valve through intraoperative suturing to compensate for the function of the original ileocecal valve. The control group will undergo the routine resection of the right-sided colon, including the ileocecal valve. This is a randomized controlled study. Patients enrolled will be randomly assigned to the experimental group (ileocecal valve reconstruction during surgery) or the control group (no ileocecal valve reconstruction), with no differences in other treatment procedures. After a series of follow-up observations, the research team will analyze the safety and effectiveness of the method of ileocecal valve reconstruction.

Aim of the project is to surveil results after extended lymphadenectomy for right sided colon resection for cancer with different operative techniques. Patients operated for right sided colon cancer will be involved. There are different operative methods used in terms of extend of lymphadenectomy and access (open, laparoscopic and robotic assisted) that are already implemented. The Norwegian standard operation contains less extended lymph node dissection. Patients operated by the standard method will serve as control group. Choice of access and extend of lymph node dissection in Norway is dependant on the surgeon and hospital. At Haukeland University Hospital extend and access of surgery are determined by a multidisciplinary team meeting. More radical surgery might result in more complications and the benefit for the patients in terms of oncological result and survival is uncertain. At Haukeland University Hospital, extended lymphadenectomy has been mostly performed by open surgery. During the study phase we will introduce extended lymphadenectomy by laparoscopy and robotassisted surgery. Hypothesis is that more radical surgery performed by minimal invasive surgery will result in equal or better oncological results, and less complications, shorter hospital stay and better quality of life. As method we choose a prospective observational study. All eligible patients with adenocarcinoma of the right colon without another ongoing oncological treatment for other cancers will be included. Patientdata will be prospectively registered in a web-based database. Aim of the study will be to define the optimal extend of lymphadenectomy to achieve the best oncological result. In addition, we will analyse the results dependent on the surgical access (open, laparoscopic or robotic). The assumed difference between the operative methods is small. Therefore, the study is designed and approved as a multicenter registration in order to achieve the necessary statistical power.