Laparoscopic Versus Open Right Colectomy for Cancer in the Era of Complete Mesocolic Excision with Central Vascular Ligation: Pathology and Short-Term Outcomes

Magouliotis, Dimitrios; Baloyiannis, Ioannis; Mamaloudis, Ioannis; Bompou, Effrosyni; Papacharalampous, Constantina; Tzovaras, George

doi:10.1089/lap.2020.0508

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…These articles were recent; 15 were published in the last 5 years [ 15 – 29 ], and none before 2013. Data from three studies were prospectively collected [ 17 , 24 , 28 ], two were retrospective case–control studies [ 15 , 16 ], 18 were retrospective cohort studies [ 18 , 19 , 21 – 23 , 25 – 27 , 29 – 38 ], and one was a randomised controlled trial [ 20 ]. Thirteen compared surgical techniques for CME [ 25 – 29 , 31 – 38 ].…”

Section: Resultsmentioning

confidence: 99%

Complete mesocolic excision for right hemicolectomy: an updated systematic review and meta-analysis

De Lange,

Davies,

Toso

et al. 2023

Tech Coloproctol

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Purpose Complete mesocolic excision improves lymphadenectomy for right hemicolectomy and respects the embryological planes. However, its effect on cancer-free and overall survival is questioned. Therefore, we aimed to determine the potential benefits of the technique by performing a systematic review of the literature and meta-analysis of the available evidence. Methods Web of Science, PubMed/Medline, and Embase were searched on February 22, 2023. Original studies on short- and long-term oncological outcomes of adult patients undergoing right hemicolectomy with complete mesocolic excision as a treatment for primary colon cancer were considered for inclusion. Outcomes were extracted and pooled using a model with random effects. Results A total of 586 publications were identified through database searching, and 18 from citation searching. Exclusion of 552 articles left 24 articles for inclusion. Meta-analysis showed that complete mesocolic excision increased the lymph node harvest (5 studies, 1479 patients, MD 9.62, 95% CI 5.83–13.41, p > 0.0001, I2 84%), 5-year overall survival (5 studies, 2381 patients, OR 1.88, 95% CI 1.14–3.09, p = 0.01, I2 66%), 5-year disease-free survival (4 studies, 1376 patients, OR 2.21, 95% CI 1.51–3.23, p < 0.0001, I2 0%) and decreased the incidence of local recurrence (4 studies, 818 patients, OR 0.27, 95% CI 0.09–0.79, p = 0.02, I2 0%) when compared to standard right hemicolectomy. Perioperative morbidity was similar between the techniques (8 studies, 3899 patients, OR 1.04, 95% CI 0.89–1.22, p = 0.97, I2 0%). Conclusion Meta-analysis of observational and randomised studies showed that right hemicolectomy with complete mesocolic excision for primary right colon cancer improves oncologic results without increasing morbidity/mortality. These results need to be confirmed by high-quality evidence and randomised trials in selected patients to assess who may benefit from the procedure.

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Section: Resultsmentioning

confidence: 99%

Complete mesocolic excision for right hemicolectomy: an updated systematic review and meta-analysis

De Lange,

Davies,

Toso

et al. 2023

Tech Coloproctol

View full text Add to dashboard Cite

show abstract

“…Hence, there are still doubts as to whether CME with CVL can be safely performed in laparoscopic surgery. Since the approach for mesenteric dissection and CVL in laparoscopic surgery is different from that of open surgery, various laparoscopic surgical techniques have been devised like a bottom-up, cranial-caudal, or arterial first approach [41][42][43][44][45][46][47][48]. In a recent meta-analysis, laparoscopic CME had comparable outcomes in harvested lymph nodes, longitudinal bowel length, mesenteric area, and vertical margin to open CME.…”

Section: Compatibility Of Laparoscopic Cme With Cvlmentioning

confidence: 99%

Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?

Son

Lee

et al. 2021

Ann Coloproctol

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Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

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Robot-assisted versus laparoscopic short- and long-term outcomes in complete mesocolic excision for right-sided colonic cancer: a systematic review and meta-analysis

et al. 2022

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Laparoscopic Versus Open Right Colectomy for Cancer in the Era of Complete Mesocolic Excision with Central Vascular Ligation: Pathology and Short-Term Outcomes

Cited by 3 publications

References 23 publications

Complete mesocolic excision for right hemicolectomy: an updated systematic review and meta-analysis

Complete mesocolic excision for right hemicolectomy: an updated systematic review and meta-analysis

Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?

Robot-assisted versus laparoscopic short- and long-term outcomes in complete mesocolic excision for right-sided colonic cancer: a systematic review and meta-analysis

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