Morphometric analysis and lymph node yield in laparoscopic complete mesocolic excision performed by supervised trainees

West, Nicholas P.; Kennedy, Robin H.; Magro, Tania; Luglio, Gaetano; Sala, S.; Jenkins, John T.; Quirke, Philip

doi:10.1002/bjs.9602

Cited by 40 publications

(21 citation statements)

References 23 publications

(47 reference statements)

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“…In CME sigmoid resections the length of resected bowel is longer 4,27,28 to ensure sufficient length and perfusion of the anastomosis, and the left flexure is often mobilized. Injury to the spleen can occur during this mobilization.…”

Section: Discussionmentioning

confidence: 99%

Short-term outcomes after complete mesocolic excision compared with ‘conventional’ colonic cancer surgery

Bertelsen

Neuenschwander

Jansen

et al. 2016

British Journal of Surgery

181

134

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Section: Discussionmentioning

confidence: 99%

Short-term outcomes after complete mesocolic excision compared with ‘conventional’ colonic cancer surgery

Bertelsen

Neuenschwander

Jansen

et al. 2016

British Journal of Surgery

181

134

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“…Of note, with complete mesocolic excision (CME), a standardized surgical procedure is now available that leads to better surgical specimens and allows improved quality control. Therefore, future studies dealing with lymph node yield in colon cancer surgery should be done with pathologically graded CME specimens to increase comparability [42]. …”

Section: Discussionmentioning

confidence: 99%

Lymph node retrieval in colorectal cancer: determining factors and prognostic significance

Betge

Harbaum

Pollheimer

et al. 2017

Int J Colorectal Dis

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PurposeThe study aimed to analyze clinicopathological factors that determine the extent of lymph node retrieval and to evaluate its prognostic impact in patients with colorectal cancer (CRC).MethodsThe number of retrieved lymph nodes was analyzed in 381 CRC specimens. Lymph node count was related to different clinicopathological variables by binary logistic regression. Progression-free survival (PFS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method and Cox regression models.ResultsThe median number of retrieved lymph nodes was 20 (mean 21 ± 10, range 1–65) in right-sided, 13 (16 ± 10, 1–66) in left-sided, and 15 (18 ± 11, 3–64) in rectal tumors. The number of retrieved lymph nodes was independently associated with T-classification (p < 0.001), N-classification (p = 0.014), and tumor size (p = 0.005) as well as right-sided tumor location (p = 0.012). There was no association with age, sex, tumor grade, mismatch-repair status, and lymph or blood vessel invasion. The longer the surgical specimen, the higher were the numbers of retrieved and positive lymph nodes (p < 0.001, respectively). In patients with locally advanced (T3/T4) tumors (n = 283), analysis of more than 12 lymph nodes was independently associated with PFS (HR = 0.63, p = 0.025) and CSS (HR = 0.54, p = 0.004). In the subset of T3/T4 N0 patients (n = 130), analysis of more than 12 lymph nodes similarly proved to be an independent predictor of outcome (PFS, HR = 0.48, p = 0.046; OS, HR = 0.41, p = 0.026).ConclusionThe number of retrieved lymph nodes is associated with higher tumor stage, tumor size, and right-sided location. Low lymph node count indicates adverse outcome in patients with locally advanced (T3/T4) disease.

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“…In the present study, less than 2 per cent of patients had laparoscopy‐assisted surgery. Laparoscopic CME is possible with similarly large specimens, although this does not guarantee a higher node count. Both approaches require surgical skills and optimal pathological examination.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of patients with colonic carcinoma before, during and after implementation of complete mesocolic excision

Merkel

Weber

Matzel

et al. 2016

British Journal of Surgery

120

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Morphometric analysis and lymph node yield in laparoscopic complete mesocolic excision performed by supervised trainees

Abstract: Laparoscopic CME can be performed to the same standard as open surgery by supervised trainees. However, this did not increase the lymph node yield.

Cited by 40 publications

References 23 publications

Short-term outcomes after complete mesocolic excision compared with ‘conventional’ colonic cancer surgery

Short-term outcomes after complete mesocolic excision compared with ‘conventional’ colonic cancer surgery

Lymph node retrieval in colorectal cancer: determining factors and prognostic significance

Prognosis of patients with colonic carcinoma before, during and after implementation of complete mesocolic excision

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