Japan Digestive Disease Week 2025
International Poster Session5 (JDDW)
October 31, 9:30–10:10, Room 15 (Kobe International Exhibition Hall No.1 Building Digital Poster Venue)
IP-24_S
Transforming Lymphadenectomy Quality through Outermost Layer-oriented Dissection: The Next Breakthrough in Robotic Right-Sided Colectomy
- 1
- Department of Surgery, Toyokawa City Hospital
Background:
Perivascular lymphadenectomy along the outermost layer has shown effectiveness in gastric and esophageal surgeries. This study applies the technique to robotic right-sided colectomies for colon cancer, reporting short-term outcomes.
Methods:
From January 2021 to December 2024, 161 patients underwent right-sided colectomy and were divided into two groups: outermost layer-oriented lymphadenectomy (Group O) and conventional lymphadenectomy (Group N). Clinicopathological differences were analyzed, with propensity score matching (PSM) applied to adjust for confounders.
Results:
Group O (35 patients, all robotic) had more preoperative anticoagulant/antiplatelet use but no significant differences in comorbidities. Operative time was longer (P=0.006), with more intracorporeal anastomoses (P<0.0001), higher lymph node yield (P=0.04), and longer distal resection margins (P=0.00003). Multivariate analysis identified outermost layer-oriented dissection (P=0.02), ASA-PS 2 or 3 (P<0.004), and Stage II disease (P=0.04) as independent predictors of increased lymph node yield. After PSM (31 per group), Group O had 1.17 times more lymph nodes (P=0.001), longer distal margins (P=0.011), and 70% fewer complications (P=0.034), with no differences in hospital stay, ICU admission, reoperation, or anastomotic leakage.
Conclusion:
Outermost layer-oriented dissection in robotic right-sided colectomy improves lymphadenectomy quality and reduces complications without increasing postoperative risks, suggesting it as a safe and effective approach.
Perivascular lymphadenectomy along the outermost layer has shown effectiveness in gastric and esophageal surgeries. This study applies the technique to robotic right-sided colectomies for colon cancer, reporting short-term outcomes.
Methods:
From January 2021 to December 2024, 161 patients underwent right-sided colectomy and were divided into two groups: outermost layer-oriented lymphadenectomy (Group O) and conventional lymphadenectomy (Group N). Clinicopathological differences were analyzed, with propensity score matching (PSM) applied to adjust for confounders.
Results:
Group O (35 patients, all robotic) had more preoperative anticoagulant/antiplatelet use but no significant differences in comorbidities. Operative time was longer (P=0.006), with more intracorporeal anastomoses (P<0.0001), higher lymph node yield (P=0.04), and longer distal resection margins (P=0.00003). Multivariate analysis identified outermost layer-oriented dissection (P=0.02), ASA-PS 2 or 3 (P<0.004), and Stage II disease (P=0.04) as independent predictors of increased lymph node yield. After PSM (31 per group), Group O had 1.17 times more lymph nodes (P=0.001), longer distal margins (P=0.011), and 70% fewer complications (P=0.034), with no differences in hospital stay, ICU admission, reoperation, or anastomotic leakage.
Conclusion:
Outermost layer-oriented dissection in robotic right-sided colectomy improves lymphadenectomy quality and reduces complications without increasing postoperative risks, suggesting it as a safe and effective approach.
- Index Term 1: Right-sided colon cancer
- Index Term 2: Lymphadenectomy