Complete mesocolic excision in right‐sided colon cancer does not increase severe short‐term postoperative adverse events

Bernhoff, R.; Sjövall, Annika; Buchli, Christian; Granath, Fredrik; Holm, Torbjörn

doi:10.1111/codi.13950

Cited by 20 publications

(17 citation statements)

References 20 publications

(31 reference statements)

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“…Laparoscopic colorectal cancer surgery, which has an obvious minimally invasive advantage in the abdominal cavity, has become one of the most established surgical methods used for gastrointestinal cancer surgery [15,16] . For the better application of CMEs in laparoscopic hemicolectomies for right colon carcinoma cases, the following points have been summarized in the literature [8,12,17,18] and in our clinical experience. First, a CME presents the concept of fine anatomy.…”

Section: Discussionmentioning

confidence: 99%

Safety and Short-term Efcacy of a Laparoscopic Complete Mesocolic Excision for the Surgical Treatment of Right Hemicolon Cancer

Li¹,

Meng²,

Chen³

2018

Clin Surg Res Commun

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Objective: This study was designed to evaluate the safety and short-term efficacy of a laparoscopic complete mesocolic excision (CME) in patients with right hemicolon cancer. Methods: A total of 88 patients with right hemicolon cancer were retrospectively reviewed. Forty patients underwent laparoscopic CMEs, and 48 patients underwent open CMEs. The clinical data were analyzed and the outcomes were compared between the two groups. Result: There was no significant difference between the laparoscopic CME group and open CME group with regard to the harvested lymph node number (16.60±3.20 vs. 15.33±3.10, respectively, P=0.060), hospital stay length (18.15±5.17 days vs. 17.21±4.47 days, respectively, P=0.360), and postoperative complications (10.0% vs. 10.4%, respectively, P=0.950). The operation time in the laparoscopic CME group (3.02±0.55 hours) was significantly longer than that in the open CME group (2.58±0.50 hours, P=0.004). The time to first flatus (3.28±0.75 days vs 3.92±0.71 days, respectively, P=0.001) and getting out of bed time (1.95±0.75 days vs 3.54±0.71 days, respectively, P=0.001) were both earlier in the laparoscopic CME group than in the open CME group. Conclusion: A laparoscopic CME is a safe and effective minimally invasive surgery for the treatment of right hemicolon cancer.

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Section: Discussionmentioning

confidence: 99%

Safety and Short-term Efcacy of a Laparoscopic Complete Mesocolic Excision for the Surgical Treatment of Right Hemicolon Cancer

Li¹,

Meng²,

Chen³

2018

Clin Surg Res Commun

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show abstract

“…There was no association between plane of excision or tissue morphometry and post-operative complication, suggesting that more extensive tissue dissection potentially associated with 'good' quality surgery does not increase post-operative morbidity. Indeed, one concern over CME is the potential morbidity associated with the extensive tissue dissection that comes with central vascular ligation [20]; that said, as our surgeries were not routinely 'CVL dissections', this study cannot specifically add to this debate. The odds of postoperative complication were increased two-fold in patients undergoing open surgery.…”

Section: Discussionmentioning

confidence: 99%

What factors determine specimen quality in colon cancer surgery? A cohort study

West

Scott

et al. 2020

Int J Colorectal Dis

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Tenets of 'good-quality' colon cancer surgery include mesocolic plane dissection to preserve an intact mesocolic fascia/peritoneum, and excision of sufficient mesocolon for adequate lymphadenectomy. However, it remains controversial what clinicopathological factors determine 'good-quality' surgery, and whether quality of surgery influences morbidity/mortality. This study documents the quality of colon cancer surgery at a quaternary-referral centre and identifies factors that influence quality of surgery and postoperative outcomes. Methods:Consecutive patients who underwent resection for colon adenocarcinoma at St. James's University Hospital, Leeds, UK (2015-2017) were included. Primary outcome measures included: (i) plane of mesocolic dissection, prospectively assessed; and (ii) tissue morphometry (area of mesentery and vascular pedicle length). Other histopathological data were extracted from a prospective database. Clinical data were obtained from the National Bowel Cancer Audit and individual records. Results:405 patients were included (mean: 69.6yrs). The majority (67.4%) of specimens were mesocolic plane dissections. Median area of mesentery excised was 12,085.4mm 2 . Median vascular pedicle length was 89.3mm. Post-operative complication was recorded in one-third of patients. Mesocolic plane excision was associated with open surgery (OR 1.80, 95%CI 1.05-3.09), especially in emergency colectomy. Open resections also had a greater mesentery

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“…In terms of perioperative outcomes, the study coming from Peking University People's Hospital Beijing revealed no differences for postoperative complication rate, with less intraoperative blood loss and one day shorter hospital stay for the CME patients (see Table 2) (1). Analysis of the short-term postoperative adverse outcomes from the Swedish Colorectal Cancer Registry revealed a proportion of CME resections of 14.8% in the 90-day reoperation or mortality group vs. 19.5% in the control group (17). The odds ratio for short-term mortality or reoperation after CME was 0.82 (95% CI, 0.47-1.10, P=0.15), with lower values in the later part of the study and high-volume centers (17).…”

Section: Perioperative Outcomesmentioning

confidence: 99%

“…Analysis of the short-term postoperative adverse outcomes from the Swedish Colorectal Cancer Registry revealed a proportion of CME resections of 14.8% in the 90-day reoperation or mortality group vs. 19.5% in the control group (17). The odds ratio for short-term mortality or reoperation after CME was 0.82 (95% CI, 0.47-1.10, P=0.15), with lower values in the later part of the study and high-volume centers (17). Analysis of a consecutive patients series after the introduction of CME technique revealed a complication rate of 47%, with severe complications (grade III and IV Clavien Dindo) in 15% of cases (18).…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Complete mesocolic excision for colon cancer is technically challenging but the most oncological appealing

Negoi

Beuran

Hostiuc

et al. 2018

Transl. Gastroenterol. Hepatol

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Complete mesocolic excision in right‐sided colon cancer does not increase severe short‐term postoperative adverse events

Abstract: The present study does not indicate that CME surgery is associated with an increased risk of severe adverse events such as 90-day mortality or reoperation.

Cited by 20 publications

References 20 publications

Safety and Short-term Efcacy of a Laparoscopic Complete Mesocolic Excision for the Surgical Treatment of Right Hemicolon Cancer

Safety and Short-term Efcacy of a Laparoscopic Complete Mesocolic Excision for the Surgical Treatment of Right Hemicolon Cancer

What factors determine specimen quality in colon cancer surgery? A cohort study

Complete mesocolic excision for colon cancer is technically challenging but the most oncological appealing

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