Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome

Siani, Luca Maria; Lucchi, Andrea; Berti, Pierluigi; Garulli, Gianluca

doi:10.1016/j.amjsurg.2016.10.005

Cited by 37 publications

(32 citation statements)

References 28 publications

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“…Because papers reporting long‐term survival were scarce, we assigned OS, DFS and DSS to the same index, indicated in our study as survival. Six studies described effect outcomes (Table ). CME had positive effects on 5‐year survival (HR 0.33, 95% CI: 0.13–0.81), 3‐year survival (HR 0.58, 95% CI: 0.39–0.86) and 3‐year survival for Stage III disease (HR 0.69, 95% CI: 0.60–0.80) compared with NCME (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The Hohenberger et al study [4] updated its data in 2016, and we selected the updated study [19]. Finally, 12 studies [14,[18][19][20][21][22][23][24][25][26][27][28] with 8586 patients (3610 in the CME group and 4976 in the NCME group) were included in our study ( Fig. 1).…”

Section: Study Identification and Characteristicsmentioning

confidence: 99%

“…Because papers reporting long-term survival were scarce, we assigned OS, DFS and DSS to the same index, indicated in our study as survival. Six studies [19,20,23,[25][26][27] described effect outcomes ( and 3-year survival for Stage III disease (HR 0.69, 95% CI: 0.60-0.80) compared with NCME ( Fig. 4).…”

Section: Cme Survival Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Safety, quality and effect of complete mesocolic excision vs non‐complete mesocolic excision in patients with colon cancer: a systemic review and meta‐analysis

et al. 2017

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Section: Resultsmentioning

confidence: 99%

Section: Study Identification and Characteristicsmentioning

confidence: 99%

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Safety, quality and effect of complete mesocolic excision vs non‐complete mesocolic excision in patients with colon cancer: a systemic review and meta‐analysis

et al. 2017

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“…During the latest years, the western concept of complete mesocolic excision with central vascular ligation (CME-CVL) 5 and the eastern D3 lymphadenectomy 6 proved their oncological superiority over conventional colonic resections, with lower 5-year local recurrence rate and better overall survival 7 . The surgical safety, better perioperative results and non-inferior long-term oncological outcomes were proved for the laparoscopic CME-CVL 8 or D3 lymphadenectomy (Supplementary Table I ) 9 , 10 . However, these surgical procedures are technically difficult and associated with more intraoperative organ injuries and severe non-surgical complications 11 .…”

Section: Introductionmentioning

confidence: 96%

Surgical Anatomy of the Superior Mesenteric Vessels Related to Colon and Pancreatic Surgery: A Systematic Review and Meta-Analysis

Negoi

Beuran

Hostiuc

et al. 2018

Sci Rep

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The surgeon dissecting the base of the mesenterium, around the superior mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the superior mesenteric vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the superior mesenteric vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

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“…A total of 600 patients were included in the largest study from Siani, which was published in 2017 [22]. With 81% of patients having undergone a pathologically confirmed complete mesocolic resection, disease-free survival and local recurrence rates after 5 years accounted for 78.3% and 6.4%, respectively.…”

Section: Results Of Open and Laparoscopic Cme As A Benchmarkmentioning

confidence: 99%

Complete mesocolic excision in minimally invasive surgery of colonic cancer: do we need the robot?

et al. 2020

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Summary Background Robotic surgery offers favorable prerequisites for complex minimally invasive surgeries which are delivered by higher degrees of freedom, improved instrument stability, and a perfect visualization in 3D which is fully surgeon controlled. In this article we aim to assess its impact on complete mesocolic excision (CME) in colon cancer and to answer the question of whether the current evidence expresses a need for robotic surgery for this indication. Methods Retrospective analysis and review of the current literature on complete mesocolic excision for colon cancer comparing the outcome after open, laparoscopic, and robotic approaches. Results Complete mesocolic excision results in improved disease-free survival and reduced local recurrence, but turns out to be complex and prone to complications. Introduced in open surgery, the transfer to minimally invasive surgery resulted in comparable results, however, with high conversion rates. In comparison, robotic surgery shows a reduced conversion rate and a tendency toward higher lymph node yield. Data, however, are insufficient and no high-quality studies have been published to date. Almost no oncologic follow-up data are available in the literature. Conclusion The current data do not allow for a reliable conclusion on the need of robotic surgery for CME, but show results which hypothesize an equivalence if not superiority to laparoscopy. Due to recently published technical improvements for robotic CME and supplementary features of this method, we suppose that this approach will gain in importance in the future.

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Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome

Cited by 37 publications

References 28 publications

Safety, quality and effect of complete mesocolic excision vs non‐complete mesocolic excision in patients with colon cancer: a systemic review and meta‐analysis

Safety, quality and effect of complete mesocolic excision vs non‐complete mesocolic excision in patients with colon cancer: a systemic review and meta‐analysis

Surgical Anatomy of the Superior Mesenteric Vessels Related to Colon and Pancreatic Surgery: A Systematic Review and Meta-Analysis

Complete mesocolic excision in minimally invasive surgery of colonic cancer: do we need the robot?

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