Advertisement

Right Colectomy with Complete Mesocolic Excision: Four-arm Technique

  • Giuseppe SpinoglioEmail author
  • Alessandra Marano
  • Fabio Priora
  • Ferruccio Ravazzoni
  • Giampaolo Formisano
Chapter
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

Minimally invasive surgery is gaining worldwide acceptance in the treatment of colonic cancer and the advantages over the traditional open approach are well known [1, 2, 3]. Unfortunately, during recent decades, the outcomes of patients after colon cancer resection have not improved to the same degree as for rectal cancer, whose treatment with total mesorectal excision (TME) is universally accepted as the standard of care. The complete mesocolic excision (CME), first reported by Hohenberger and colleagues in 2008 [4], seems to produce better long-term outcomes when compared to standard lymphadenectomy by following the same embryological-based principles introduced by Heald for rectal cancer more than 20 years ago [5]. However, well-conducted randomized studies are needed to confirm its efficacy.

Keywords

Total Mesorectal Excision Superior Mesenteric Vein Transverse Mesocolon Complete Mesocolic Excision Intracorporeal Anastomosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Jayne DG, Thorpe HC, Copeland J et al (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645PubMedCrossRefGoogle Scholar
  2. 2.
    Fleshman J, Sargent DJ, Green E et al (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 246:655–662PubMedCrossRefGoogle Scholar
  3. 3.
    Buunen M, Veldkamp R, Hop WC et al (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52PubMedCrossRefGoogle Scholar
  4. 4.
    Hohenberger W, Weber K, Matzel K et al (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome. Colorectal Dis 11:354–364PubMedCrossRefGoogle Scholar
  5. 5.
    Heald RJ (1988) The ‘Holy Plane’ of rectal surgery. J R Soc Med 81:503–508PubMedCentralPubMedGoogle Scholar
  6. 6.
    Jamali FR, Soweid AM, Dimassi H et al (2008) Evaluating the degree of difficulty of laparoscopic colorectal surgery. Archives Surg 143:762–767CrossRefGoogle Scholar
  7. 7.
    Bae SU, Saklani AP, Lim DR et al (2014) Laparoscopic-assisted versus open complete mesocolic excision and central vascular ligation for right-sided colon cancer. Ann Surg Oncol 21:2288–2294PubMedCrossRefGoogle Scholar
  8. 8.
    Adamina M, Manwaring ML, Park KJ, Delaney CP (2012) Laparoscopic complete mesocolic excision for right colon cancer. Surg Endosc 26:2976–2980PubMedCrossRefGoogle Scholar
  9. 9.
    Feng B, Ling TL, Lu AG et al (2013) Completely medial versus hybrid medial approach for laparoscopic complete mesocolic excision in right hemicolon cancer. Surg Endosc 28:477–483PubMedCrossRefGoogle Scholar
  10. 10.
    Feng B, Sun J, Ling TL et al (2012) Laparoscopic complete mesocolic excision (CME) with medial access for right-hemi colon cancer: feasibility and technical strategies. Surg Endosc 26:3669–3675PubMedCrossRefGoogle Scholar
  11. 11.
    Gouvas N, Pechlivanides G, Zervakis N et al (2012) Complete mesocolic excision in colon cancer surgery: a comparison between open and laparoscopic approach. Colorectal Dis 14:1357–1364PubMedCrossRefGoogle Scholar
  12. 12.
    Shin JW, Amar AH, Kim SH et al (2014) Complete mesocolic excision with D3 lymph node dissection in laparoscopic colectomy for stages II and III colon cancer: long-term oncologic outcomes in 168 patients. Tech Coloproctol [Epub ahead of print]Google Scholar
  13. 13.
    Kang J, Kim IK, Kang SI et al (2014) Laparoscopic right hemicolectomy with complete mesocolic excision. Surg Endosc 28:2747–2451PubMedCrossRefGoogle Scholar
  14. 14.
    Storli KE, Sondenaa K, Furnes B, Eide GE (2013) Outcome after introduction of complete mesocolic excision for colon cancer is similar for open and laparoscopic surgical treatments. Digestive Surg 30:317–327CrossRefGoogle Scholar
  15. 15.
    Park JS, Choi GS, Park SY et al (2012) Randomized clinical trial of robot-assisted versus standard laparoscopic right colectomy. Brit J Surg 99:1219–1226PubMedCrossRefGoogle Scholar
  16. 16.
    Zimmern A, Prasad L, Desouza A (2010) Robotic colon and rectal surgery: a series of 131 cases. World J Surg 34:1954–1958PubMedCrossRefGoogle Scholar
  17. 17.
    Trastulli S, Desiderio J, Farinacci F et al (2013) Robotic right colectomy for cancer with intracorporeal anastomosis: short-term outcomes from a single institution. Int journal J Colorect Dis 28:807–814CrossRefGoogle Scholar
  18. 18.
    D’Annibale A, Pernazza G, Morpurgo E et al (2010) Robotic right colon resection: evaluation of first 50 consecutive cases for malignant disease. Ann Surg Oncol 17:2856–2862PubMedCrossRefGoogle Scholar
  19. 19.
    Shin JY (2012) Comparison of short-term surgical outcomes between a robotic colectomy and a laparoscopic colectomy during early experience. J Korean Soc Coloproctol 28:19–26PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    de Souza AL, Prasad LM, Park JJ et al (2010) Robotic assistance in right hemicolectomy: is there a role? Dis Colon Rectum 53:1000–1006CrossRefGoogle Scholar
  21. 21.
    Casillas MA Jr, Leichtle SW, Wahl WL et al (2014) Improved perioperative and short-term outcomes of robotic versus conventional laparoscopic colorectal operations. Am J Surg 208:33–40PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Giuseppe Spinoglio
    • 1
    Email author
  • Alessandra Marano
  • Fabio Priora
  • Ferruccio Ravazzoni
  • Giampaolo Formisano
  1. 1.Department of General and Oncologic Surgery“Ss. Antonio e Biagio” HospitalAlessandriaItaly

Personalised recommendations