Journal ArticleDOI
Standardized surgery for colonic cancer: complete mesocolic excision and central ligation--technical notes and outcome.
TLDR
This technique is focused on an intact package of the tumour and its main lymphatic drainage and this technique is nowadays accepted worldwide for optimal rectal cancer surgery.Abstract:
Objective Total mesorectal excision (TME) as proposed by R.J. Heald more than 20 years ago, is nowadays accepted worldwide for optimal rectal cancer surgery. This technique is focused on an intact package of the tumour and its main lymphatic drainage.
This concept can be translated into colon cancer surgery, as the mesorectum is only part of the mesenteric planes which cover the colon and its lymphatic drainage like envelopes. According to the concept of TME for rectal cancer, we perform a concept of complete mesocolic excision (CME) for colonic cancer. This technique aims at the separation of the mesocolic from the parietal plane and true central ligation of the supplying arteries and draining veins right at their roots.
Method Prospectively obtained data from 1329 consecutive patients of our department with RO-resection of colon cancer between 1978 and 2002 were analysed. Patient data of three subdivided time periods were compared.
Results By consequent application of the procedure of CME, we were able to reduce local 5-year recurrence rates in colon cancer from 6.5% in the period from 1978 to 1984 to 3.6% in 1995 to 2002. In the same period, the cancer related 5-year survival rates in patients resected for cure increased from 82.1% to 89.1%.
Conclusion The technique of CME in colon cancer surgery aims at a specimen with intact layers and a maximum of lymphnode harvest. This is translated into lower local recurrence rates and better overall survival.read more
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Journal ArticleDOI
Five‐year follow‐up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer
TL;DR: The UK Medical Research Council CLASICC trial assessed the safety and efficacy of laparoscopically assisted surgery in comparison with open surgery for colorectal cancer and the 5‐year follow‐up analysis is presented.
Journal ArticleDOI
Complete Mesocolic Excision With Central Vascular Ligation Produces an Oncologically Superior Specimen Compared With Standard Surgery for Carcinoma of the Colon
TL;DR: 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, which may partially explain the high 5-year survival rates reported inErlangen.
Journal ArticleDOI
Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer
B L Green,H C Marshall,Fiona Collinson,Philip Quirke,Pierre J. Guillou,David G. Jayne,Julia Brown +6 more
TL;DR: The results of long‐term follow‐up of the UK Medical Research Council trial of laparoscopically assisted versus open surgery for colorectal cancer are presented.
Journal ArticleDOI
Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer: A Systematic Review and Meta-analysis
Fausto Petrelli,Gianluca Tomasello,Karen Borgonovo,Michele Ghidini,Luca Turati,Pierpaolo Dallera,Rodolfo Passalacqua,Giovanni Sgroi,Sandro Barni +8 more
TL;DR: CC side should be acknowledged as a criterion for establishing prognosis in all stages of disease, and should represent a stratification factor for future adjuvant studies.
Journal ArticleDOI
Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study
Claus Anders Bertelsen,Anders Ulrich Neuenschwander,Jens Erik Jansen,Michael Wilhelmsen,Anders Kirkegaard-Klitbo,Jutaka Reilin Tenma,Birgitte Bols,Peter Ingeholm,Leif Ahrenst Rasmussen,Lars V. Jepsen,Else Refsgaard Iversen,Bent Kristensen,Ismail Gögenur +12 more
TL;DR: It is indicated that CME surgery is associated with better disease-free survival than is conventional colon cancer resection for patients with stage I-III colon adenocarcinoma.
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