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
Prognostic impact of lymph node harvest and lymph node ratio in patients with colon cancer
TL;DR: The number of examined lymph nodes increased in the study period, and lymph node ratio was a stronger prognostic factor than the total number of lymph nodes examined, in patients with stage I to III disease.
Journal ArticleDOI
Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations
TL;DR: A review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intra-corporeal anastomosis after right hemicolectomy are presented.
Journal ArticleDOI
Complete mesocolic excision in colorectal cancer: a systematic review
TL;DR: Assessment of the use of CME for colon cancer by evaluating the technique and its clinical outcome demonstrated that CME removes significantly more tissue around the tumour including maximal lymph node clearance.
Journal ArticleDOI
Surgical treatment and survival from colorectal cancer in Denmark, England, Norway, and Sweden: a population-based study
Sara Benitez Majano,Chiara Di Girolamo,Chiara Di Girolamo,Bernard Rachet,Camille Maringe,Marianne Grønlie Guren,Bengt Glimelius,Lene Hjerrild Iversen,Edrun Andrea Schnell,Kristina Lundqvist,Jane Christensen,Melanie Morris,Michel P Coleman,Sarah Walters +13 more
TL;DR: Survival from colorectal cancer has been shown to be lower in Denmark and England than in comparable high-income countries, and the proportion of patients treated with resectional surgery was consistently lowest in England.
Journal ArticleDOI
Robotic Versus Laparoscopic Right Colectomy with Complete Mesocolic Excision for the Treatment of Colon Cancer: Perioperative Outcomes and 5-Year Survival in a Consecutive Series of 202 Patients.
Giuseppe Spinoglio,Paolo Bianchi,Alessandra Marano,Fabio Priora,Luca Matteo Lenti,Ferruccio Ravazzoni,Wanda Petz,Simona Borin,Dario Ribero,Giampaolo Formisano,Emilio Bertani +10 more
TL;DR: Robotic assistance was beneficial for performing intracorporeal anastomosis and dissection as evidenced by the lower conversion rates and further robotic experience may shorten the operative time.
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