Routine CT scan one year after surgery can be used to estimate the level of central ligation in colon cancer surgery

Routine CT evaluation of central vascular ligation in patients undergoing complete mesocolic excision for sigmoid colon cancer

“…Unlike rectal cancer, where the concepts of total mesorectal excision have been established as the gold standard for tumour resection, the concept of CME surgery in colon cancer is still questioned. Recent studies have demonstrated the utility of simple CT-based measures for verification of the surgical procedure [14,15,17,18]. This may allow for a more thorough evaluation of the technical aspects of CME surgery, namely the extent of lymphadenectomy and the level of vascular ligation.…”

“…In comparison with the pathological grading of the embryological plane and quality of surgery, objective measures for the level and extent of vascular ligation are lacking [13]. Due to the lack of pathological and reliable clinical markers, in vivo assessment using postoperative CT scans has previously been demonstrated as a feasible clinical reference marker [14][15][16][17][18][19]. However, data regarding the pathological workup and effects on surgical morbidity and oncological outcomes are sparse.…”

Macroscopic Evaluation of Colon Cancer Resection Specimens

“…A Danish study quantified that the mean stump length measured by CT was 38 mm (95% CI: 33–43 mm), whereas the target within the CME with CVL context is approximately 10 mm [ 61 ]. If increased radicality improves outcomes, there is potential to use this post-operatively for immediate feedback, as well as for follow-up, because the arterial stump does not significantly change length over time [ 64 ]. However, a CT conducted immediately after surgery is unlikely to be palatable due to increased radiation exposure, so this may need to be done on the routine 12-month post-operative scan.…”