The basis of complete mesocolic excision represents the continuation and the
conceptual idea of the total mesorectal excision of rectum (TME) which was
described and promoted by R. J. Heald in 1983, and the point is to make the
excision of the contaminated portion of the colon with the tumor in his
visceral (embryonic) sheath without any damages of the central ligature of
supplying vessels and preservation of the autonomous nervous system.
According to this concept, colon and rectum, in their embryonic genesis, were
belted on both sides with visceral fascia, as an envelope and through
mesocolon, there was vascular and lymphatic drainage, while the ligature at
the source of the vascular pedicle provided the removal of the largest number
of lymphatic nodes. Surgical, sharp dissection, i.e. separation of visceral
fasciae of the colon from the parietal peritoneum without any damage and
total mobilization of the entire mesocolon with ligation in the very source
of the supplying blood vessels. The scope of surgical mobilization of
mesocolon is defined by the tumor localization. Literature provides numerous
data supporting the fact that such technique enables the reduction in number
of local recidives from 6.5% to 3.6% and increase of the five-year survival
from 82.1% to 89 %. CME technique provides optimal treatment of the colon
cancer.
Short-Term and Long-Term Outcomes of Complete Mesocolic Excision with Central Vascular Ligation for Ascending Colon Cancer: Single Institution
