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International Journal of Colorectal Disease

, Volume 32, Issue 1, pp 139–141 | Cite as

Laparoscopic complete mesocolic excision for right-sided colon cancer using a cranial approach: anatomical and embryological consideration

  • Takeru Matsuda
  • Takeshi Iwasaki
  • Yasuo Sumi
  • Kimihiro Yamashita
  • Hiroshi Hasegawa
  • Masashi Yamamoto
  • Yoshiko Matsuda
  • Shingo Kanaji
  • Taro Oshikiri
  • Tetsu Nakamura
  • Satoshi Suzuki
  • Yoshihiro Kakeji
Short Communication

Abstract

Background

Complete mesocolic excision (CME) with central vascular ligation (CVL) should be employed for the treatment of colon cancer patients because of its superior oncological outcomes. However, this technique is technically challenging in laparoscopic right hemicolectomy because of the anatomical complexity of the transverse mesocolon.

Methods

We focused on the embryology and anatomy of the transverse mesocolon to overcome the difficulty of this surgery. The validity and efficacy of a cranial approach in achieving CME with CVL in laparoscopic right hemicolectomy was elucidated from the embryological point of view.

Results

In total, 28 consecutive patients with right-sided colon cancer were treated by laparoscopic right hemicolectomy using a cranial approach. There were no conversion to open surgery or switching to another approach. Using this approach, torsion and fusion of the transverse mesocolon, which occurred during embryological development, could be reversed and the complex anatomy of the transverse mesocolon could be simplified before performing CVL of colonic vessels.

Conclusions

A cranial approach is considered valid and useful for CME with CVL in laparoscopic right hemicolectomy from the embryological point of view.

Keywords

Embryology Anatomy CME Cranial approach 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Takeru Matsuda
    • 1
  • Takeshi Iwasaki
    • 2
  • Yasuo Sumi
    • 3
  • Kimihiro Yamashita
    • 1
  • Hiroshi Hasegawa
    • 1
  • Masashi Yamamoto
    • 1
  • Yoshiko Matsuda
    • 1
  • Shingo Kanaji
    • 1
  • Taro Oshikiri
    • 1
  • Tetsu Nakamura
    • 1
  • Satoshi Suzuki
    • 1
  • Yoshihiro Kakeji
    • 1
  1. 1.Division of Gastrointestinal Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of SurgeryNational Hospital Organization Kobe Medical CenterKobeJapan
  3. 3.Division of Minimally Invasive Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan

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