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Mesenteric Considerations in Surgery of the Colon and Rectum

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The Mesenteric Organ in Health and Disease

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Abstract

Surgical management of the mesocolon and mesorectum during colon and rectal resections is based upon the primary diagnosis. In general, complete excision is recommended during resections for malignancy but not required in benign disease. Crohn’s disease may benefit from a more radical mesenteric excision. Surgical embryology and anatomy have a key function for understanding optimal colon and rectal cancer surgery. The vascular anatomy determines the individual extent of resection depending on the location of the disease in colon and rectum. Due to potential lymph node spread, more comprehensive resections are necessary for tumors of the transverse colon, hepatic and splenic flexure. Pathology has to thoroughly evaluate individual quality of surgery and should report if mesorectum and mesocolon are intact and complete in the specimen. Total mesorectal excision (TME) and complete mesocolic excision (CME) describe valid standards of good quality rectal and colon cancer surgery.

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Authors and Affiliations

  1. Digestive Disease and Surgery Institute, Department of Colorectal Surgery, Cleveland Clinic, 9500 Euclid Avenue, A30, Cleveland, OH, 44195, USA

    Hermann Kessler

  2. Department of Gastroenterology and Nutrology, Service of Colorectal Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Mariane G. M. Camargo

  3. Department of Surgery, Division of Colon and Rectal Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kristen T. Crowell

Authors
  1. Hermann Kessler
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  2. Mariane G. M. Camargo
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  3. Kristen T. Crowell
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Correspondence to Hermann Kessler .

Editor information

Editors and Affiliations

  1. Department of Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA

    Eli D. Ehrenpreis

  2. Department of Surgery, University of Chicago Medicine, Chicago, IL, USA

    John C. Alverdy

  3. Department of Colon and Rectal Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner

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Kessler, H., Camargo, M.G.M., Crowell, K.T. (2021). Mesenteric Considerations in Surgery of the Colon and Rectum. In: Ehrenpreis, E.D., Alverdy, J.C., Wexner, S.D. (eds) The Mesenteric Organ in Health and Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-71963-0_36

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  • DOI: https://doi.org/10.1007/978-3-030-71963-0_36

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71962-3

  • Online ISBN: 978-3-030-71963-0

  • eBook Packages: MedicineMedicine (R0)

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