Single-port laparoscopic complete mesocolic excision and central vascular ligation for caecal cancer with apical lymph node metastasis - a video vignette

2018 ◽  
Vol 20 (7) ◽  
pp. 643-644
Author(s):  
S. U. Bae ◽  
W. K. Jeong ◽  
S. K. Baek
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Single Port ◽  
Complete Mesocolic Excision ◽  
Central Vascular Ligation ◽  
Node Metastasis ◽  
Vascular Ligation ◽  
Mesocolic Excision ◽  
Video Vignette

Complete Mesocolic Excision With Central Vascular Ligation Produces an Oncologically Superior Specimen Compared With Standard Surgery for Carcinoma of the Colon

2010 ◽  
Vol 28 (2) ◽  
pp. 272-278 ◽  
Author(s):  
Nicholas P. West ◽  
Werner Hohenberger ◽  
Klaus Weber ◽  
Aristoteles Perrakis ◽  
Paul J. Finan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Colonic Cancer ◽  
Complete Mesocolic Excision ◽  
Central Vascular Ligation ◽  
Lymph Node Yield ◽  
Carcinoma Of The Colon ◽  
Vascular Ligation ◽  
Standard Specimens ◽  
Mesocolic Excision ◽  
Node Yield

Purpose The plane of surgery in colonic cancer has been linked to patient outcome although the optimal extent of mesenteric resection is still unclear. Surgeons in Erlangen, Germany, routinely perform complete mesocolic excision (CME) with central vascular ligation (CVL) and report 5-year survivals of higher than 89%. We aimed to further investigate the importance of CME and CVL surgery for colonic cancer by comparison with a series of standard specimens. Methods The fresh photographs of 49 CME and CVL specimens from Erlangen and 40 standard specimens from Leeds, United Kingdom, for primary colonic adenocarcinoma were collected. Precise tissue morphometry and grading of the plane of surgery were performed before comparison to histopathologic variables. Results CME and CVL surgery removed more tissue compared with standard surgery in terms of the distance between the tumor and the high vascular tie (median, 131 v 90 mm; P < .0001), the length of large bowel (median, 314 v 206 mm; P < .0001), and ileum removed (median, 83 v 63 mm; P = .003), and the area of mesentery (19,657 v 11,829 mm2; P < .0001). In addition, CME and CVL surgery was associated with more mesocolic plane resections (92% v 40%; P < .0001) and a greater lymph node yield (median, 30 v 18; P < .0001). Conclusion Surgeons in Erlangen routinely practicing CME and CVL surgery remove more mesocolon and are more likely to resect in the mesocolic plane when compared with standard excisions. This, along with the associated greater lymph node yield, may partially explain the high 5-year survival rates reported in Erlangen.

scholarly journals Robotic complete mesocolic excision with central vascular ligation for right colonic tumours – a propensity score-matching study comparing with standard laparoscopy

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
J S Khan ◽  
A Ahmad ◽  
M Odermatt ◽  
D G Jayne ◽  
N Z Ahmad ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Operative Time ◽  
Complete Mesocolic Excision ◽  
Central Vascular Ligation ◽  
Lymph Node Yield ◽  
Vascular Ligation ◽  
Mesocolic Excision ◽  
Node Yield ◽  
Disease Free

Abstract Background Laparoscopic complete mesocolic excision (CME) of the right colon with central vascular ligation (CVL) is a technically demanding procedure. This study retrospectively evaluated the feasibility, safety and oncological outcomes of the procedure when performed using the da Vinci® robotic system. Methods A prospective case series was collected over 3 years for patients with right colonic cancers treated by standardized robotic CME with CVL using the superior mesenteric vessels first approach. The CME group was compared to a 2 : 1 propensity score-matched non-CME group who had conventional laparoscopic right colectomy with D2 nodal dissection. Primary outcomes were total lymph node harvest and length of specimen. Secondary outcomes were operative time, postoperative complications, and disease-free and overall survival. Results The study included 120 patients (40 in the CME group and 80 in the non-CME group). Lymph node yield was higher (29 versus 18, P = 0.006), the specimen length longer (322 versus 260 mm, P = 0.001) and median operative time was significantly longer (180 versus 130 min, P &lt; 0.001) with robotic CME versus laparoscopy, respectively. Duration of hospital stay was longer with robotic CME, although not significantly (median 6 versus 5 days, P = 0.088). There were no significant differences in R0 resection rate, complications, readmission rates and local recurrence. A trend in survival benefit with robotic CME for disease-free (P = 0.0581) and overall survival (P = 0.0454) at 3 years was documented. Conclusion Robotic CME with CVL is feasible and, although currently associated with a longer operation time, it provides good specimen quality, higher lymph node yield and acceptable morbidity, with a disease-free survival advantage.

scholarly journals Complete mesocolic excision and central vascular ligation for right colon cancer: an introduction for abdominal radiologists

2019 ◽  
Vol 44 (11) ◽  
pp. 3518-3526
Author(s):  
David D. B. Bates ◽  
Viktoriya Paroder ◽  
Chandana Lall ◽  
Neeraj Lalwani ◽  
Maria Widmar ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Complete Mesocolic Excision ◽  
Right Colon ◽  
Central Vascular Ligation ◽  
Right Colon Cancer ◽  
Vascular Ligation ◽  
Mesocolic Excision
Sign in / Sign up

Export Citation Format

Share Document