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Caudal-to-Cranial Approach for Right Colectomy with Complete Mesocolic Excision in Colon Cancer: A Systematic Review and Meta-analysis

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Abstract

Background

A newly emerging approach “caudal to cranial” with complete mesenteric excision (CME) has recently been proposed for right colectomy in patients with right colon cancer. To date, only a few studies about this approach have appeared. Our study aims to investigate the safety and efficacy of this new technique.

Methods

A systematic review of the literature was conducted to evaluate the evidence regarding short- and long-term outcomes after the caudal-to-cranial approach (CCA). Methodological Index for Non-Randomized Studies was used to evaluate methodological quality. The risk of bias was assessed using Robvis tool. Meta-analyses have been conducted for the outcomes of studies comparing CCA with other techniques.

Results

We found six studies from 2017 to 2021 with a total of 594 patients. The postoperative complications and oncological outcomes were acceptable. Two studies comparing CCA to medial-to-lateral approach were included in the meta-analysis. No differences were found between the techniques regarding to operative time, length of hospital stay, overall morbidity, and number of lymph nodes.

Conclusion

Although the interpretation of our findings may be restrained by methodological limitations, risk of bias, and the absence of well-designed randomized controlled trials, CCA with CME in right-sided colon cancer may be a feasible and safe procedure.

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Data Availability

The data that support the findings of this study are available from the corresponding author, [MM], upon reasonable request.

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Authors and Affiliations

  1. A21 Surgery Department, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Tunis El Manar University, Rue 9 Avril, 1007, Tunis, Bab Saadoun, Tunisia

    Mohamed Maatouk, Ghassen Hamdi Kbir, Aymen Mabrouk, Anis Ben Dhaw, Karim Haouet & Mounir Ben Moussa

  2. Private practice surgeon, Tunis, Tunisia

    Yacine Ben Safta

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  1. Mohamed Maatouk
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  2. Yacine Ben Safta
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  3. Ghassen Hamdi Kbir
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  4. Aymen Mabrouk
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  5. Anis Ben Dhaw
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  6. Karim Haouet
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  7. Mounir Ben Moussa
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Contributions

Writing—original draft: Maatouk M, Hamdi Kbir G. Conceptualization: Ben Safta Y, Haouet K. Formal analysis: Mabrouk A, Ben Dhaou A. Review and editing: Ben Moussa M.

Corresponding author

Correspondence to Mohamed Maatouk.

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No ethical approval is required as this research project is a systematic review of previous studies.

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The authors declare no competing interest.

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Maatouk, M., Safta, Y.B., Kbir, G.H. et al. Caudal-to-Cranial Approach for Right Colectomy with Complete Mesocolic Excision in Colon Cancer: A Systematic Review and Meta-analysis. J Gastrointest Canc 54, 739–750 (2023). https://doi.org/10.1007/s12029-022-00894-0

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