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
Citations
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Journal ArticleDOI
Open Right Hemicolectomy Is a Safe and Suitable Procedure for Surgical Training: A Comparative Study With 133 Patients.
TL;DR: Oncological open right hemicolectomy is a safe and suitable training procedure for residency training under standardized conditions and there were no significant differences in risk factors, operating time, postoperative complications, and mortality between the groups.
Book ChapterDOI
Comparative effectiveness in colon and rectal cancer.
TL;DR: Issues of controversy exist where the appropriate treatment is not clear, and this chapter will examine these issues and discuss how they may be resolved.
Journal ArticleDOI
Comparative Study between Total Mesocolic Exesion Versus Conventional Right Hemicolectomy in management of Tumors of the Right Colon
TL;DR: The primary report and portrayal of the total mesocolic extraction (CME) with focal vascular ligation (CVL) with very noteworthy oncological results and a general 5-year endurance coming to up to 70% for stage III colon malignant growth patients is presented.
Journal ArticleDOI
Plastic wound protectors decreased surgical site infections following laparoscopic-assisted colectomy for colorectal cancer: A retrospective cohort study.
TL;DR: It is indicated that the use of a plastic wound protector during laparoscope-assisted colectomy does reduce postoperative wound infection rates, and the wound protectors are beneficial for specimen extraction and digestive tract reconstruction.
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