Efficacy Of Complete Mesocolic Excision Research Articles

The Efficacy of Complete Mesocolic Excision with Central Vessel Ligation Technique on Lymph Nodes and Safety Margins Compared with Conventional Surgery for Colon Cancer Treatment: Prospective Observational Study

The Efficacy of Complete Mesocolic Excision with Central Vessel Ligation Technique on Lymph Nodes and Safety Margins Compared with Conventional Surgery for Colon Cancer Treatment: Prospective Observational Study

Complete mesocolic excision for right colon cancer—state of art: a systematic review of the literature

: Complete mesocolic excision (CME) is a new concept of right hemicolectomy for colon cancer (CC) set up to improve oncological outcomes and based on three main points: dissection in the embryological plane, central vascular ligation (CVL) and resection of a sufficient length of bowel. During this last decade, many doubts and questions have been arised about safety and efficacy of CME. We conducted a systematic review of the literature to investigate the safety, quality and survival outcomes of this procedure. Literature search resulted in 659 articles found and after the selection process 21 studies properly fulfilling inclusion and exclusion criteria were included. The total number of collected patients was 7,402 (mean age 65.42 years, 51.27% men). The weighted mean number of lymph nodes retrieved was 27.45 and the mean number of metastatic nodes was 1.34. Surgical complication and overall operative mortality rate were 5.5% and 0.5% respectively. Five-year overall survival (OS) and disease-free survival (DFS) rates were 84.3% and 82.8%. Available data from literature have several limitations mostly including non-homogeneous and incomplete reports together with no evidence from randomized control trial (RCT) studies. Therefore, to date, the quality of evidence is low and does not consistently support the superiority of CME over the standard right hemicolectomy, despite a reported trend to improved survival with comparable operative morbidity and mortality. More reliable data from large sample size RCTs are needed before CME can be recommended as the standard of care for right CC.

The Efficacy Of Complete Mesocolic Excision With Central Vessel Ligation Technique On Lymph Nodes And Safety Margins Compared With Conventional Surgery For Colon Cancer Treatment

The Efficacy Of Complete Mesocolic Excision With Central Vessel Ligation Technique On Lymph Nodes And Safety Margins Compared With Conventional Surgery For Colon Cancer Treatment

Efficacy of complete mesocolic excision in radical operation for right colon cancer

To investigate the efficacy of complete mesocolic excision (CME) in the radical operation for right hemicolon cancer. Clinical data of 336 cases of right hemicolon cancer undergoing radical resection, including 218 cases of CME surgery group and 118 cases of traditional surgery group, from January 2005 to December 2014 in Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed. Intraoperational events, perioperative status and postoperative survival were compared between the two groups. The baseline information was not significantly different between the two groups (all P>0.05). The number of harvested lymph nodes in CME and traditional group was 11.4±0.3 and 9.3±0.5 respectively(P=0.000) and the proportion of greater than or equal to 12 lymph nodes per case was 47.3%(103/218) and 28.8%(34/118)(P=0.002), which both were significantly different. The operation time in CME and traditional group was (147.2±2.9) and (148.8±3.9) minutes, which was not significantly different (P>0.05), whereas operative blood loss was (125.7±7.5) and (305.1±20.5) milliliters in CME and traditional group with significant difference (P=0.000). Postoperative hospital stay was (12.9±0.9) and (16.3±1.0) days in CME and traditional group with significant difference (P=0.018), while the time to postoperative liquid intake and normal diet was not significantly different between two groups (both P>0.05). The morbidity of postoperative complication of CME group was lower compared to traditional group (14.2%, 31/218 vs. 24.6%, 29/118), which was significantly different (P=0.018). Among them, infection occurred in 19 (8.7%) cases and 21 (17.8%) cases with significant difference between the two groups (P=0.014). The average time of follow-up was (34.5±1.2) months and (27.9±1.5) months in CME and traditional group, and the five-year survival rate was 85.6% and 78.0% with significant difference(P=0.043). Moreover, 102 cases underwent laparoscopic-assisted CME and 116 cases underwent open CME in CME group. The 5-year survival rate was 89.8% and 82.2% in laparoscopic and open group with significant difference (P=0.048). Compared with traditional radical resection, CME radical resection for right hemicolon cancer can harvest more lymph nodes, decrease operative blood loss, lower the riskof postoperative complication, shorten the postoperative hospital stay, and increase the 5-year survival rate. Furthermore, laparoscopic-assisted CME has more advantages.

Application of complete mesocolic excision in stage III colon cancer

To evaluate the efficacy of complete mesocolic excision (CME) for stage III colon cancer. Clinical data of 100 patients diagnosed as stage III colon cancer in our hospital from July 2011 to July 2013 were analyzed retrospectively. Fifty-four patients in CME group underwent complete mesocolic excision and 46 patients in control group underwent traditional radical surgery. Lymphadenectomy, postoperative specimen quality and short-term clinical efficacy were compared between two groups. The number of gross dissected lymph nodes and positive dissected lymph nodes in CME group were 26.7 ± 2.6 and 4.3 ± 1.4, which were significantly higher than those in control group (22.9 ± 3.7 and 2.8 ± 1.2) (all P<0.01). There was statistical significance in surgical C-class specimens of CME group were found in 45 cases (83.3%), which were significantly higher than those of control group (29 cases, 63.0%) (P<0.05). The postoperative complication rate of two groups was the same without significant difference(both 13.0%, P>0.05). CME is safe and effective for stage III colon cancer, which can improve the quality of surgical specimen and increase the number of dissected lymph nodes, but do not elevate the morbidity of postoperative complication.