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Complete Mesocolic Excision

J Reibetanz, C T Germer
No abstract text is available yet for this article.
February 13, 2019: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Akira Ishikawa, Takahiko Tanigawa, Yoshihiro Mori, Ichiro Higuchi, Yosuke Akiyama, Yasunori Hasuike
Surgery for obstructive colon cancer was highly invasive due to poor nutritional status of patients, risk of emergency surgery, and unavoidable colostomy formerly. However, recently, we have been able to perform laparoscopic elective surgery safely without colostomy, by using self-expanding metallic stents(SEMS). Laparoscopic colectomy for transverse colon cancer is inherently very difficult because of variations in the vascular system, small number of patients, and absence of large, randomized trials. Laparoscopic complete mesocolic excision(CME)for colectomy has been shown to be technically feasible and effective...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Ming Li Ho, Cheryl Chong, Shen Ann Yeo, Chee Yung Ng
INTRODUCTION: Laparoscopic colorectal surgery is increasingly performed worldwide due to its multiple advantages over traditional open surgery. In the surgical treatment of right-sided colonic tumours, the latest technique is laparoscopic right hemicolectomy with complete mesocolic excision (lapCME), which aims to lower the rate of local recurrence and maximise survival as compared to standard laparoscopic right hemicolectomy (lapS). METHODS: We conducted a retrospective analysis of our initial experience with lapCME in Singapore General Hospital between 2012 and 2015...
January 15, 2019: Singapore Medical Journal
J Reibetanz, C T Germer
No abstract text is available yet for this article.
January 3, 2019: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Sung Uk Bae, Seung Yoon Yang, Byung Soh Min
BACKGROUND: Recently, an operative strategy involving complete mesocolic excision (CME) and central vascular ligation (CVL) for colonic cancer has been introduced. We aimed to describe our initial experience and assess the long-term outcomes of robotic modified CME (mCME) and CVL (mCME+CVL) for right-sided colon cancer. METHODS: Of the 677 patients with histologically confirmed, right-sided colon adenocarcinoma who underwent curative mCME+CVL between February 2008 and October 2016, 43 who were treated entirely using the robotic approach were included in this retrospective study...
December 17, 2018: International Journal of Colorectal Disease
Wouter Willaert, Sarah Cosyns, Wim Ceelen
The progression of colon cancer (CC) involves hematogenous and lymphatic spread to locoregional lymph nodes (LN), distant LN, and metastatic sites including the liver. The biological mechanisms that govern CC progression remain elusive. The Halsted model assumes an orderly, stepwise progression from the primary tumor to nearby nodes, henceforth to anatomically more distant nodes, and ultimately to distant organs. The Fisher model, on the other hand, regards the release of metastatic cells as early and essentially random events...
2018: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Jin-Tung Liang, John Huang, Tzu-Chun Chen, Ji-Shiang Hung
To clarify the anatomic concept of Toldt fascia, based on the literature review and the surgical anatomic dissection using laparoscopic or robotic approach. We undertook review of the historic literature and surgical videos from 250 patients with colorectal cancer operated on laparoscopically or robotically to discuss the surgical implications of Toldt fascia in complete mesocolic excision for colon cancer. Toldt fascia, sandwiched by the overlying mesothelial layer of the mesocolon and underlying mesothelial layer of the retroperitoneum, comprised loose fibrous tissues with minute vessels inside, and was contiguous from the ileocecal mesentery radix to the upper rectum...
December 3, 2018: Asian Journal of Surgery
Ionut Negoi, Mircea Beuran, Sorin Hostiuc, Massimo Sartelli, Federico Coccolini, Mihaela Vartic, Thomas Pinkney
No abstract text is available yet for this article.
2018: Translational Gastroenterology and Hepatology
S H Emile, S D Wexner
AIM: Three-dimensional (3D) printing has been recognized as a revolutionary technological innovation that has benefitted numerous disciplines, including medicine. The present systematic review aimed to demonstrate the current applications of 3D printing in colorectal surgery along with the limitations and potential future applications of this innovation. METHOD: A PRISMA-compliant systematic literature search of studies that applied 3D printing in colorectal surgery in the period from January 1990 to July 2018 was conducted...
November 20, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Corrado Pedrazzani, Enrico Lazzarini, Giulia Turri, Eduardo Fernandes, Cristian Conti, Valeria Tombolan, Filippo Nifosì, Alfredo Guglielmi
BACKGROUND: Colectomies performed according to complete mesocolic excision (CME) principles have demonstrated an improvement in the quality of surgical specimen and a potential improvement of long-term results. Laparoscopic CME right hemicolectomy is considered a demanding procedure and adopted in few centers from the West. The main purpose of this paper is to present a video showing our technique for laparoscopic CME right hemicolectomy and to analyze our short-term results to prove its safety...
November 14, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Zirui He, Sen Zhang, Pei Xue, Xialin Yan, Leqi Zhou, Jianwen Li, Mingliang Wang, Aiguo Lu, Junjun Ma, Lu Zang, Hiju Hong, Feng Dong, Hao Su, Jing Sun, Luyang Zhang, Minhua Zheng, Bo Feng
BACKGROUND: To investigate the safety and feasibility of the completely medial access by page-turning approach (CMAP) for laparoscopic right hemi-colectomy. METHODS: In this retrospective study, the data from 72 patients who underwent laparoscopic right hemi-colectomy with CMAP were analyzed and compared with data from 124 patients who underwent the conventional medial approach performed by the same surgical team from September 2011 to March 2017. RESULT: Complete mesocolic excision (CME) was achieved in 67 of 72 patients (93...
November 1, 2018: Surgical Endoscopy
Meng Yue, Yue Wang, Zhen-Hua Kang, Xu Wang, Lei Wang
PURPOSE: To compare the short- and long-term outcomes of open and laparoscopic complete mesocolic excision (CME) for transverse colon cancer (TCC) using propensity score matching (PSM). METHODS: The clinical and follow-up data of 97 TCC patients who were subjected to CME in our institution from January 2012 to October 2017 were retrospectively analyzed. The patients were divided into the laparoscopic and open group according to the surgical approaches. The patients were 1:1 matched using the PSM method...
July 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Akira Arimoto, Takeru Matsuda, Hiroshi Hasegawa, Kimihiro Yamashita, Tetsu Nakamura, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
INTRODUCTION: Anatomical evaluation of the splenic flexure vein is essential for complete mesocolic excision with central vascular ligation when treating patients with splenic flexure cancer. Although there have been several studies relating to the arterial branches of the splenic flexure, very limited data are available regarding the variation in venous anatomy in this region. METHODS: Sixty-six patients with colorectal cancer who underwent preoperative 3-D CT between April 2016 and April 2017 were included in this retrospective study...
October 24, 2018: Asian Journal of Endoscopic Surgery
Christoph Werner Strey, Christoph Wullstein, Michel Adamina, Ayman Agha, Heiko Aselmann, Thomas Becker, Robert Grützmann, Werner Kneist, Matthias Maak, Benno Mann, Kurt Thomas Moesta, Norbert Runkel, Clemens Schafmayer, Andreas Türler, Thilo Wedel, Stefan Benz
BACKGROUND: Complete mesocolic excision is gradually becoming an established oncologic surgical principle for right hemicolectomy. However, the procedure is technically demanding and carries the risk of serious complications, especially when performed laparoscopically. A standardized procedure that minimizes technical hazards and facilitates teaching is, therefore, highly desirable. METHODS: An expert group of surgeons and one anatomist met three times. The initial aim was to achieve consensus about the surgical anatomy before agreeing on a sequence for dissection in laparoscopic CME...
December 2018: Surgical Endoscopy
Eiji Shinto, Jin-Ichi Hida, Hideyuki Ike, Hirotoshi Kobayashi, Yojiro Hashiguchi, Kazuo Hase, Hideki Ueno, Kenichi Sugihara
BACKGROUND: Complete mesocolic excision is becoming popular in colon cancer surgery in Western countries, and in the tumor-node-metastasis (TNM) classification of rectal cancer, a part of the lateral pelvic lymph nodes is classified as regional. However, the appropriateness of TNM staging according to the assessment of nodal status exclusively by extended lymphadenectomy remains unclear. PATIENTS AND METHODS: Using a nationwide multicenter database in Japan, we retrospectively analyzed 6866 patients with stage III colorectal cancer (CRC) treated with extended (D3) dissection...
December 2018: Annals of Surgical Oncology
Qingyong Chen, Xiaoming Shuai, Libo Chen
OBJECTIVE: To explore the safety and feasibility of the combined medial and caudal approach in laparoscopic D3 lymphadenectomy plus complete mesocolic excision(CME) for right hemicolectomy in the treatment of right hemicolon cancer complicated with incomplete ileus. METHODS: Clinical data of 65 patients with incomplete obstructive right-sided colon cancer (T1 to 4M0) diagnosed by abdominal CT enhanced scan or MRI and/or electric colonscope undergoing laparoscopic right hemicolectomy (D3 lymphadenectomy + CME) at Department of Emergency Medicine and Department of Gastrointestinal Surgery from June 2014 to June 2017 were retrospectively analyzed...
September 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Giuseppe Spinoglio, Paolo P Bianchi, Alessandra Marano, Fabio Priora, Luca M Lenti, Ferruccio Ravazzoni, Wanda Petz, Simona Borin, Dario Ribero, Giampaolo Formisano, Emilio Bertani
BACKGROUND: During the past decade, the concept of complete mesocolic excision (CME) has emerged as a possible strategy to minimize recurrence for right colon cancers. The purpose of this study was to compare robotic versus laparoscopic CME in performing right colectomy for cancer. METHODS: Pertinent data of all patients who underwent robotic or laparoscopic right colectomy with CME using a Pfannenstiel incision and intracorporeal anastomosis performed between October 2005 and November 2015 were entered in a prospectively maintained database...
September 14, 2018: Annals of Surgical Oncology
Xiangbing Deng, Tao Hu, Mingtian Wei, Qingbin Wu, Tinghan Yang, Wenjian Meng, Ziqiang Wang
BACKGROUND: Complete mesocolic excision (CME) with central ligation or D3 lymphadenectomy has been reported to provide increased lymph node retrieval with the prospect of superior oncological results in colon cancer. However, right hemicolectomy with CME or D3 lymphadenectomy by laparoscopy is considered to be a technically challenging and time-consuming procedure with a higher risk of causing intraoperative injuries. Here, we introduce a novel laparoscopic approach for the D3 right hemicolectomy and report its feasibility, safety, and efficacy in cancer clearance...
September 2018: Langenbeck's Archives of Surgery
Noura Alhassan, Mei Yang, Nathalie Wong-Chong, A Sender Liberman, Patrick Charlebois, Barry Stein, Gerald M Fried, Lawrence Lee
BACKGROUND: Complete mesocolic excision (CME) is advocated based on oncologic superiority, but not commonly performed in North America. Many data are case series with few comparative studies. Our aim was to perform a systematic review comparing outcomes between CME and non-CME colectomy. METHODS: A systematic review was performed according to PRISMA guidelines of MEDLINE, EMBASE, HealthStar, Web of Science, and Cochrane Library. Studies were included if they compared conventional resection (non-CME) to CME for colon cancer...
September 12, 2018: Surgical Endoscopy
Mohamed Abdelkhalek, Ahmed Setit, Francesco Bianco, Andrea Belli, Adel Denewer, Tamer Fady Youssef, Armando Falato, Giovanni Maria Romano
PURPOSE: Revolutions have occurred over the last 3 decades in the management of patients with colorectal cancer. Most advances were in rectal cancer surgery, especially after the introduction of the total mesorectal excision (TME) by Heald. However, no parallel advances regarding colon cancer surgeries have occurred. In 2009, Hohenberger introduced a new concept trying to translate the survival advantages of TME to patients with colon cancer. This relatively new concept of a complete mesocolic excision (CME) with central vascular ligation (CVL) in the management of patients with colon cancer represents an evolution in operative technique...
August 2018: Annals of Coloproctology
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