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Minimally invasive complete mesocolic excision for right colon cancer

Complete mesocolic excision (CME) with central vascular ligation (CVL) follows the same principles as the total mesorectal excision (TME) in the rectum of following the embryological planes for right‐sided cancers. The number of lymph nodes yielded increased with a resultant improvement in the oncol...

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Autores principales: Park, Hyunmi, Lee, Tae‐Hoon, Kim, Seon‐Hahn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240146/
https://www.ncbi.nlm.nih.gov/pubmed/32490338
http://dx.doi.org/10.1002/ags3.12331
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author Park, Hyunmi
Lee, Tae‐Hoon
Kim, Seon‐Hahn
author_facet Park, Hyunmi
Lee, Tae‐Hoon
Kim, Seon‐Hahn
author_sort Park, Hyunmi
collection PubMed
description Complete mesocolic excision (CME) with central vascular ligation (CVL) follows the same principles as the total mesorectal excision (TME) in the rectum of following the embryological planes for right‐sided cancers. The number of lymph nodes yielded increased with a resultant improvement in the oncological outcomes and by reducing local recurrence rates. Hohenberger's radical CME and CVL and the East's modified CME with D3 lymphadenectomy, which traditionally followed the embryological plane dissection for most of its intraabdominal cancer resection, have both shown to harvest significantly higher number of lymph nodes leading to a higher overall survival rate than the traditional right hemicolectomies of the West. To achieve the oncologically superior excision of the CME, awareness of the significant vascular anatomical variation will enhance the precision of the oncosurgery as well as minimize the risk of vascular complications. There has been an increasing body of evidence emerging on the safety of minimally invasive surgery (MIS); both its oncological safety as well as complication rates in the hands of expert and trained surgeons. The surgical technique of a CME right hemicolectomy is described step by step to aid standardization. There is mounting evidence that CME + CVL/ D3 improves survival in patients with colon cancer. Whilst the technical aspect of MIS is more challenging than the left, with a standardized technique and systematic teaching method, safety and benefits for patients can be achieved.
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spelling pubmed-72401462020-06-01 Minimally invasive complete mesocolic excision for right colon cancer Park, Hyunmi Lee, Tae‐Hoon Kim, Seon‐Hahn Ann Gastroenterol Surg Review Articles Complete mesocolic excision (CME) with central vascular ligation (CVL) follows the same principles as the total mesorectal excision (TME) in the rectum of following the embryological planes for right‐sided cancers. The number of lymph nodes yielded increased with a resultant improvement in the oncological outcomes and by reducing local recurrence rates. Hohenberger's radical CME and CVL and the East's modified CME with D3 lymphadenectomy, which traditionally followed the embryological plane dissection for most of its intraabdominal cancer resection, have both shown to harvest significantly higher number of lymph nodes leading to a higher overall survival rate than the traditional right hemicolectomies of the West. To achieve the oncologically superior excision of the CME, awareness of the significant vascular anatomical variation will enhance the precision of the oncosurgery as well as minimize the risk of vascular complications. There has been an increasing body of evidence emerging on the safety of minimally invasive surgery (MIS); both its oncological safety as well as complication rates in the hands of expert and trained surgeons. The surgical technique of a CME right hemicolectomy is described step by step to aid standardization. There is mounting evidence that CME + CVL/ D3 improves survival in patients with colon cancer. Whilst the technical aspect of MIS is more challenging than the left, with a standardized technique and systematic teaching method, safety and benefits for patients can be achieved. John Wiley and Sons Inc. 2020-04-07 /pmc/articles/PMC7240146/ /pubmed/32490338 http://dx.doi.org/10.1002/ags3.12331 Text en © 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Articles
Park, Hyunmi
Lee, Tae‐Hoon
Kim, Seon‐Hahn
Minimally invasive complete mesocolic excision for right colon cancer
title Minimally invasive complete mesocolic excision for right colon cancer
title_full Minimally invasive complete mesocolic excision for right colon cancer
title_fullStr Minimally invasive complete mesocolic excision for right colon cancer
title_full_unstemmed Minimally invasive complete mesocolic excision for right colon cancer
title_short Minimally invasive complete mesocolic excision for right colon cancer
title_sort minimally invasive complete mesocolic excision for right colon cancer
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240146/
https://www.ncbi.nlm.nih.gov/pubmed/32490338
http://dx.doi.org/10.1002/ags3.12331
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