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
Impact of Proximal Vascular Ligation on Survival of Patients with Colon Cancer
TL;DR: Current data support a standardized anatomic approach to colonic resection with complete resection of the mesocolic envelope and ligation at least to the D2 level, and proposed benefits of a D3 or central nodal dissection along root vessels in colon cancer is improving accuracy of lymph node evaluation.
Journal ArticleDOI
Lymph node metastases in the gastrocolic ligament in patients with colon cancer.
Claus Anders Bertelsen,Birgitte Bols,Peter Ingeholm,Jens Einar Jansen,Lars V. Jepsen,Bent Kristensen,Anders Ulrich Neuenschwander,Ismail Gögenur +7 more
TL;DR: Metastases in the gastroepiploic or infrapyloric lymph nodes can be found in patients with tumors located in the proximity of the flexures or in the transverse colon, with special focus on recurrence risk and long-term survival.
Journal ArticleDOI
Extended Lymphadenectomy in Colon Cancer is Crucial
TL;DR: Extended lymphadenectomy is oncologically relevant only when it is combined with removal of the primary tumor with adequate longitudinal clearance, an intact complete mesocolon, and high vascular tie.
Journal ArticleDOI
Elevated preoperative carcinoembryonic antigen (CEA) and Ki67 is predictor of decreased survival in IIA stage colon cancer.
Yifan Peng,Lin Wang,Jin Gu +2 more
TL;DR: An elevated preoperative serum level of CEA and high expression of Ki67 in tumor tissue were predictors of poor prognosis for patients with stage IIA colon cancer and should be considered candidates for receiving intensive surveillance.
Journal ArticleDOI
Morphometric analysis and lymph node yield in laparoscopic complete mesocolic excision performed by supervised trainees.
Nicholas P. West,Robin H. Kennedy,T Magro,Gaetano Luglio,S Sala,John T. Jenkins,Philip Quirke +6 more
TL;DR: Complete mesocolic excision with central vascular ligation (CME) produces an optimal colonic cancer specimen.
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