scholarly journals Achieving complete mesocolic excision (CME) for colon cancer by laparoscopy

2014 ◽  
Vol 61 (2) ◽  
pp. 17-21
Author(s):  
Evaghelos Xynos
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Approach ◽  
Complete Mesocolic Excision ◽  
Open Approach ◽  
Mesorectal Excision ◽  
Regional Lymph Nodes ◽  
Oncological Outcomes ◽  
Mesocolic Excision ◽  
Oncological Results ◽  
Standard Laparoscopic Surgery

In accordance to the total mesorectal excision concept for rectal cancer, that of the complete mesocolic excision (CME) for colon cancer has been recently developed. CME involves dissection along the embryological planes, ligation and division of the supplying vessels at their origin and removal of a specimen with intact fascia and peritoneum, adequate distal and proximal bowel margin as well as the maximum number of the regional lymph nodes. CME surgery seems to achieve better oncological outcomes, in terms of local recurrence and survival, as compared to standard colectomy. CME has also been attempted by the laparoscopic approach. Provided that the tumour is located at the left or right and not at the transverse, a specimen of high quality can be resected, similar to that obtained by the open approach. There is also evidence that the oncological results of laparoscopic CME are superior to those achieved by the standard laparoscopic surgery, and similar to those achieved by open CME.

scholarly journals Laparoscopic versus Open Complete Mesocolic Excision for Right Colon Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ali Zedan ◽  
Essam Elshiekh ◽  
Mohamed I Omar ◽  
Mohamad Raafat ◽  
Salah M. Khallaf ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Approach ◽  
Complete Mesocolic Excision ◽  
Right Hemicolectomy ◽  
Oncologic Outcomes ◽  
Time Interval ◽  
Open Approach ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Mesocolic Excision

Background and Objectives. The use of complete mesocolic excision (CME) technique seems to be gaining popularity in the management of cancer colon. We aim to compare the laparoscopic approach for CME with the open approach in right colon cancer treatment with regard to the feasibility, safety, and perioperative and oncologic outcomes. Patients and Methods. A prospective study which included all patients that underwent radical right hemicolectomy for pathologic confirmed stage II or stage III tumor with CME at South Egypt Cancer Institute, Assiut University, from January 2012 to December 2019. Patients were grouped according to the surgical approach into the laparoscopic colectomy (LCME) group (n = 48) or open colectomy (OCME) group (n = 48). Results. The mean operative time was significantly longer in the LCME group than that in the OCME group with less mean intraoperative blood loss. Conversion was required in 4 patients (8.3%) in the LCME group. The use of laparoscopy increased the number of harvested lymph nodes compared to the open approach (39.81 ± 16.74 vs. 32.65 ± 12.28, respectively, P = 0.010 ). The laparoscopic approach was associated with a shorter time interval to first flatus as well as shorter time interval to liquid and normal diet after surgery. The postoperative hospital stay was significantly shorter in the LCME group. The complication rate was slightly lower in the LCME (14.7%) than in the OCME group (27.2%) ( P = 0.252 ). The 3-year OS in the LCME group was similar to that in OCME (78.2% vs. 63.2%, respectively, P value = 0.423). The three-year DFS in the laparoscopic group was higher (74.5%) than the open group (60.0%), but did not reach statistical significance ( P value = 0.266). Conclusions. In conclusion, laparoscopic CME right hemicolectomy is a technically feasible and safe procedure if surgeon expertise is present. LCME has long-term oncologic outcomes (recurrence and survival) comparable to open surgery for management of patients with stage II or III colon cancer.

Oncological outcomes after complete mesocolic excision in right‐sided colon cancer: a population‐based study

2021 ◽  
Author(s):  
Richard Bernhoff ◽  
Annika Sjövall ◽  
Fredrik Granath ◽  
Torbjörn Holm ◽  
Anna Martling ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Complete Mesocolic Excision ◽  
Population Based ◽  
Population Based Study ◽  
Oncological Outcomes ◽  
Mesocolic Excision

scholarly journals Robotic Complete Mesocolic Excision with Central Vascular Ligation for Right Colon Cancer: Surgical Technique and Short-term Outcomes

2020 ◽  
Vol 11 (4) ◽  
pp. 674-683
Author(s):  
C. Ramachandra ◽  
Pavan Sugoor ◽  
Uday Karjol ◽  
Ravi Arjunan ◽  
Syed Altaf ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Open Surgery ◽  
Complete Mesocolic Excision ◽  
Right Colon ◽  
Short Term ◽  
Central Vascular Ligation ◽  
Oncological Outcomes ◽  
Right Colon Cancer ◽  
Vascular Ligation ◽  
Mesocolic Excision

Abstract Background Minimally invasive colorectal surgery has demonstrated to have the same oncological results as open surgery, with better clinical outcomes. Robotic assistance is an evolution of minimally invasive technique. Purpose The study aims to present technical details and short-term oncological outcomes of robotic-assisted complete mesocolic excision (CME) with central vascular ligation (CVL) for right colon cancer. Methodology Fifty-two consecutive patients affected by right colon cancer were operated between May 2016 and February 2020 with da Vinci Xi platform. Data regarding surgical and short-term oncological outcomes were systematically collected in a colorectal specific database for statistical analysis. Results Thirty-seven (71.15%) and 15 (28.85%) patients underwent right and extended right hemicoletomy with an extracorporeal anastomosis. Median age was 55 years. Mean operative time was 182 ± 36 min. Mean blood loss was 110 ± 90 ml. Conversion rate was 3.84% (two cases). 78.84% (41 cases) were pT3 and mean number of harvested lymph nodes was 28 ± 4. 1/52 (1.92%) had a documented anastomotic leak requiring exploratory laparotomy and diversion proximal ileostomy. Surgery-related grade IIIa–IIIb Calvien Dindo morbidity were noted in 9.61% and 1.92%, respectively. Conclusion Robotic assistance allows performance of oncological adequate dissection of the right colon with radical lymphadenectomy as in open surgery, confirming the safety and oncological adequacy of this technique, with acceptable results and short-term outcomes.

Complete mesocolic excision in colon cancer surgery: a comparison between open and laparoscopic approach

2012 ◽  
Vol 14 (11) ◽  
pp. 1357-1364 ◽  
Author(s):  
N. Gouvas ◽  
G. Pechlivanides ◽  
N. Zervakis ◽  
M. Kafousi ◽  
E. Xynos
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Approach ◽  
Complete Mesocolic Excision ◽  
Cancer Surgery ◽  
Mesocolic Excision ◽  
Colon Cancer Surgery

scholarly journals Complete mesocolic excision with central supplying vessel ligation: New technique in colon cancer treatment

2010 ◽  
Vol 18 (3) ◽  
pp. 84-85
Author(s):  
Tomislav Petrovic ◽  
Zoran Radovanovic ◽  
Milan Breberina ◽  
Brane Gavrancic
Keyword(s):  
Colon Cancer ◽  
Complete Mesocolic Excision ◽  
Lymphatic Drainage ◽  
Autonomous Nervous System ◽  
Mesorectal Excision ◽  
Mesocolic Excision ◽  
Colon And Rectum ◽  
Sharp Dissection ◽  
Numerous Data ◽  
Vessel Ligation

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.

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