Reply to Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Abstract

•Find more ESMO Clinical Practice Guidelines under: http://www.esmo.org/Guidelines •Find more ESMO Clinical Practice Guidelines under: http://www.esmo.org/Guidelines Laparoscopic surgery for the treatment of right colon cancer has rapidly evolved over the past few years. This procedure is considered as feasible and effective in terms of short-term and long-term outcomes. Laparoscopic right colectomy (LRC) is performed by a small number of surgeons and, in most of cases, it was performed with an extracorporeal anastomosis.1.Milone M. Elmore U. Di Salvo E. et al. Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers.Surg Endosc. 2015; 29: 2314-2320doi:10.1007/s00464-014-3950-7Crossref PubMed Scopus (102) Google Scholar The recent ESMO guidelines with a Level of Evidence (LE) IV reported that for right-sided colonic cancers, the benefits of laparoscopic approach are less obvious since anastomosis must be hand sewn, which requires a laparotomy.2.Labianca R. Nordlinger B. Beretta G.D. ESMO Guidelines Working Group et al.Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2013; 24: vi64-72doi:10.1093/annonc/mdt354Abstract Full Text Full Text PDF PubMed Scopus (654) Google Scholar The current state of the art for the treatment of the right colon cancers as reported by Fabozzi et al.3.Fabozzi M. Cirillo P. Corcione F. Surgical approach to right colon cancer: From open technique to robot. State of art.World J Gastrointest Surg. 2016; 8: 564-573Crossref PubMed Google Scholar in their papers, by right laparoscopic colectomy with intracorporeal anastomosis despite the technical challenging. However, in the past few years, many studies comparing the intracorporeal anastomosis (IA) versus the extracorporeal anastomosis (EA) in LRC were conducted1.Milone M. Elmore U. Di Salvo E. et al. Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers.Surg Endosc. 2015; 29: 2314-2320doi:10.1007/s00464-014-3950-7Crossref PubMed Scopus (102) Google Scholar4.Svan Oostendorp, AElfrink, WBorstlap, et al. Intracorporeal versus extracorporeal anastomosis in right hemicolectomy: a systematic review and meta-analysis. Surg EndoscEpub ahead of print: 10 Jun 2016. DOI: 10.1007/s00464-016-4982-yGoogle Scholar, 5.Hanna M.H. Hwang G.S. Phelan M.J. et al.Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis.Surg Endosc. 2016; 30: 3933-3942Crossref PubMed Scopus (53) Google Scholar, 6.Shapiro R. Keler U. Segev L. et al.Laparoscopic right hemicolectomy with intracorporeal anastomosis: short- and long-term benefits in comparison with extracorporeal anastomosis.Surg Endosc. 2016; 30: 3823-3829Crossref PubMed Scopus (82) Google Scholar, 7.JAbrisqueta, NIban˜ ez, JLuján, et al. Intracorporeal ileocolic anastomosis in patients with laparoscopic right. Surg Endosc; 30:65–72.Google Scholar, 8.CRicci, RCasadei, VAlagna, et al. A critical and comprehensive systematic review and meta-analysis of studies comparing intracorporeal and extracorporeal anastomosis in laparoscopic right hemicolectomy. Langenbecks Arch Surg. Epub ahead of print: 5 Sep 2016. DOI:10.1007/s00423-016-1509-xGoogle Scholar with a higher level of evidence. These papers assessed short-term and long-term outcomes of LRC. Milone et al1.Milone M. Elmore U. Di Salvo E. et al. Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers.Surg Endosc. 2015; 29: 2314-2320doi:10.1007/s00464-014-3950-7Crossref PubMed Scopus (102) Google Scholar in their multicentric, comparative and prospective study (LE III) evaluated the safety of IA versus EA in 512 patients submitted to an LCR. They concluded that the IA represents the better way to perform the anastomosis after LRC. van Oostendorp