Complete Mesocolic Excision and Central Vascular Ligation: History and Outcome
Surgical excision with the en-bloc removal of regional lymph nodes is currently the most promising treatment for colon cancer. Complete mesocolic excision (CME) with central vascular ligation (CVL) has recently been introduced in colon cancer surgery as a concept similar to total mesorectal excision (TME) for rectal cancer. This surgical technique involves oncologic resection with careful dissection of the mesocolon along the embryological tissue planes, which results in a colon and mesocolon specimen lined by intact fascial coverage of the tumor and containing all blood vessels, lymphatic vessels, lymph nodes, and surrounding soft tissue that may contain disseminated cancer cells. Subsequent studies have proved the feasibility and safety of the CME with CVL technique in open, laparoscopic, and even robotic surgery for colon cancer. Although the long-term survival benefit of the CME with CVL procedure has not been proven, it should be considered a standard surgical procedure in colon cancer surgery based on the anatomical and oncological backgrounds.
KeywordsComplete mesocolic excision (CME) Central vascular ligation (CVL) Outcome
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