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Complete Mesocolic Excision

Y Xiao
Laparoscopic right colectomy by the rule of complete mesocolic excision is becoming a standard operation for right colon cancer. Intraoperative iatrogenic vascular injuries are rare but disastrous complications. In addition to the dissection along the embryonic plane, reducing iatrogenic bleeding is of crucial importance to safeguard the surgical procedure. Keeping the operative field clear by gentle suction to have a good exposure is essential to identify the origin of bleeding, and then to make decision how to control the bleeding by bipolar coagulation, clipping and transection, suturing or conversion to open surgery...
August 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Claus Anders Bertelsen, Helene M Larsen, Anders U Neuenschwander, Søren Laurberg, Bent Kristensen, Katrine J Emmertsen
BACKGROUND: Complete mesocolic excision improves the long-term outcome of colon cancer but might carry a risk of bowel dysfunction. OBJECTIVE: This study aimed to investigate whether right-sided complete mesocolic excision is associated with an increased risk of long-term bowel dysfunction and reduced quality of life compared with conventional colon cancer resections. DESIGN: Data were extracted from a population-based study comparing complete mesocolic excision and conventional colon cancer resections and from a national questionnaire survey regarding functional outcome...
September 2018: Diseases of the Colon and Rectum
I Hamzaoglu, V Ozben, I Sapci, E Aytac, A Aghayeva, I A Bilgin, I E Bayraktar, B Baca, T Karahasanoglu
BACKGROUND: Proper identification of the mesocolic vessels is essential for achieving complete mesocolic excision (CME) in cases of colon cancer requiring an extended right hemicolectomy. In robotic procedures, we employed a "top down technique" to allow early identification of the gastrocolic trunk and middle colic vessels. The aim of our study was to illustrate the details of this technique in a series of 12 patients. METHODS: The top down technique consists of two steps...
August 6, 2018: Techniques in Coloproctology
Giuseppe Spinoglio, Wanda Petz, Simona Borin, Alessandra N Piccioli, Emilio Bertani
BACKGROUND: Robotic complete mesocolic excision (CME) has recently emerged as promising technique to enhance oncologic results in hemicolectomy for cancer. The potential near-infrared (NIR) fluorescence with indocyanine-green (ICG) dye for lymphatic mapping is under investigation and few small case-series are reported. METHODS: ICG solution was endoscopically injected the day before surgery in patients undergoing robotic right colectomy with CME using the Da Vinci Xi® system and the bottom to up technique...
July 23, 2018: Minerva Chirurgica
Abe Fingerhut, William T Chen, Luigi Boni, Selman Uranues
INTRODUCTION: Complete mesocolic excision for colonic cancer is similar in concept to total mesorectal excision for rectal cancer. This review aims to provide the embryological and anatomical rationale behind CME, and to review the current literature on CME, relative to the feasibility via laparoscopy, the oncological adequacy and outcomes. EVIDENCE ACQUISITION: A literature search was performed at the end of 2017 according the PRISMA guidelines for systematic reviews...
July 23, 2018: Minerva Chirurgica
Rosario Vecchio, Eva Intagliata, Salvatore Marchese, Renato Catalano
PURPOSE: Nowadays, there is no standardization in surgical procedures for treatment of colon cancer. Since its introduction, laparoscopic surgery has gained increasing interest in colorectal surgery and it is now performed worldwide for treatment of colon cancer. Following the concept of total mesocolic excision introduced by Heald in 1988 in order to reduce local recurrence after surgical treatment of mid/low rectal tumors, the idea of complete removal of the mesocolon mesocolic envelope has been developed also for colon cancer, has evolved longtime and complete mesocolic excision has been recently adopted as the optimal approach for colon cancer...
June 26, 2018: Annali Italiani di Chirurgia
Jarek Kobiela, Emilio Bertani, Wanda Petz, Cristiano Crosta, Giuseppe De Roberto, Simona Borin, Dario Ribero, Diana Baldassari, Piotr Spychalski, Giuseppe Spinoglio
In robotic right hemicolectomy for colorectal cancer (CRC), appropriate lymphadenectomy and anastomotic leak prevention are critical. Visualisation of lymph nodes and blood flow with near-infrared (NIR) fluorescence DaVinci® imaging system is a recent development. Herein, we present an improved robotic modified complete mesocolic excision (mCME) technique using indocyanine green (ICG) fluorescence. Before surgery, ICG is injected into the submucosa around the tumour with endoscopy for intraoperative detection of lymph nodes...
June 27, 2018: Journal of Minimal Access Surgery
Jörg O W Pelz, Johanna Wagner, Sven Lichthardt, Johannes Baur, Caroline Kastner, Niels Matthes, Christoph-Thomas Germer, Armin Wiegering
BACKGROUND: The treatment strategies for colorectal cancer located in the right side of the colon have changed dramatically during the last decade. Due to the introduction of complete mesocolic excision (CME) with central ligation of the vessels and systematic lymph node dissection, the long-term survival of affected patients has increased significantly. It has also been proposed that right-sided colon resection can be performed laparoscopically with the same extent of resection and equal long-term results...
June 28, 2018: World Journal of Surgical Oncology
C A Bertelsen, H Elfeki, A U Neuenschwander, S Laurberg, B Kristensen, K J Emmertsen
AIM: To investigate whether complete mesocolic excision (CME) might carry a higher risk of bowel dysfunction and subsequent reduction in quality of life compared with conventional resection. METHOD: A cross-sectional questionnaire study based on data from a national survey regarding long-term bowel function and a population-based cohort study comparing CME (study group) with conventional resection (control group). A total of 622 patients undergoing elective resection for Stage I-III sigmoid adenocarcinoma at four university colorectal centres between June 2008 and December 2014 were eligible to receive the questionnaire in mid-November 2015...
June 27, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Min Sung An, HyungJoo Baik, Se Hui Oh, Yo-Han Park, Sang Hyuk Seo, Kwang Hee Kim, Kwan Hee Hong, Ki Beom Bae
BACKGROUND: Complete mesocolic excision (CME) has been proposed for colon cancer to improve oncological outcomes. The risks and benefits of laparoscopic CME have not been examined fully. We compared short- and long-term outcomes of CME with a conventional mesocolic excision (non-CME) in laparoscopic right hemicolectomy (RHC) for right-sided colon cancer. METHODS: In total, 115 patients who underwent laparoscopic RHC with stage I-III right-sided colon cancer at Busan Paik Hospital from August 2007 to October 2011 were enrolled in this case-control study...
June 12, 2018: ANZ Journal of Surgery
Volkan Ozben, Cansu de Muijnck, Eren Esen, Erman Aytac, Bilgi Baca, Tayfun Karahasanoglu, Ismail Hamzaoglu
INTRODUCTION: Laparoscopic complete mesocolic excision (CME) for transverse colon cancer is technically challenging. Robotic technology has been developed to reduce technical limitations of laparoscopy. Yet, no data are available on the role of robotic approach for CME of transverse colon cancer. The aim of this study is to evaluate the feasibility and short-term outcomes of robotic CME in this subset of colon cancer. METHODS: A retrospective review of a prospectively maintained database of 29 consecutive patients undergoing robotic CME for transverse colon adenocarcinoma between December 2014 and December 2017 was performed...
June 7, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hisashi Shinohara, Yasunori Kurahashi, Shusuke Haruta, Yoshinori Ishida, Mitsuru Sasako
Gastrointestinal cancer surgery aims at en bloc removal of the primary tumor with its lymphatic drainage by excising organ-specific mesentery as an "intact package". This concept was advocated in colorectal cancer surgery as total mesorectal excision (TME) or complete mesocolic excision (CME) procedures, but is not directly applicable to stomach cancer as a result of the morphological complexities of the gastric mesentery. In this review, we discuss the unique anatomical features of the mesogastrium by introducing its embryology, disclose its similarity to the mesosigmoid, and then propose a theoretical concept to mesentery-based D2 gastrectomy, namely systematic mesogastric excision, which can universalize the operative strategy of stomach cancer with that of TME and CME colorectal counterparts...
January 2018: Annals of gastroenterological surgery
Volkan Ozben, Erman Aytac, Deniz Atasoy, Ilknur Erenler Bayraktar, Onur Bayraktar, Ipek Sapci, Bilgi Baca, Tayfun Karahasanoglu, Ismail Hamzaoglu
Complexity and operative risks of complete mesocolic excision (CME) seem to be important drawbacks to generalize this procedure in the surgical treatment of right colon cancer. Robotic systems have been developed to improve quality and outcomes of minimal invasive surgery. The aim of this study was to evaluate the feasibility of robotic right-sided CME and present our initial experience. A retrospective review of 37 patients undergoing totally robotic right-sided CME between February 2015 and November 2017 was performed...
May 17, 2018: Journal of Robotic Surgery
Pieter J Tanis, Roel Hompes, Willem A Bemelman
No abstract text is available yet for this article.
May 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
L W Unger, M Muckenhuber, S Riss, S Argeny, J Stift, I Mesteri, A Stift
AIM: As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph node metastases, the pathologist's dedication may have a considerable influence on postoperative survival. METHOD: The aim of this retrospective study was to assess the impact of the pathologist's dedication on lymph node detection rate and postoperative survival in patients operated on by a single experienced colorectal surgeon within a 5-year period. We assessed 229 patients undergoing total mesorectal excision or complete mesocolic excision by the senior author between 1 January 2009 and 31 December 2013...
July 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Lelin Pan, Feng Ye, Jing-Jing Liu, Xiao-Qun Ba, Qin-Song Sheng
PURPOSE: This study aimed to analyze and evaluate the feasibility of using carbon nanoparticles (CNs) to track lymph nodes (LNs) metastases in right colon tumors, especially for patients who underwent laparoscopic-assisted radical right hemicolectomy. METHOD: A total of 99 patients were enrolled in this retrospective study between November 2015 and September 2017 (control group n = 47). One day before surgery, 1 ml of CNs suspension was injected into the submucosal layer around the site of the primary lesions by colonoscopy...
August 2018: International Journal of Colorectal Disease
Shinsuke Suzuki, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Hironori Fukuoka, Hajime Ushigome, Satoshi Murahashi, Shun Miyanari, Hironori Minami, Masashi Ueno
Here, we describe our experience of laparoscopic surgery in a colon cancer patient with an ileal conduit. To our knowledge, this is the second case presented in the English-language literature. A 71-year-old woman with a history of both open anterior exenteration with ileal conduit reconstruction for bladder cancer and open cholecystectomy for cholecystitis was diagnosed with ascending colon cancer (cT3N1M0). Laparoscopic right hemicolectomy with conduit preservation was planned. After adhesiolysis, complete mesocolic excision and central vascular ligation were achieved laparoscopically without injury to the conduit or other structures...
April 6, 2018: Asian Journal of Endoscopic Surgery
Takashi Takeda, Naotsugu Haraguchi, Ayumi Yamaguchi, Mamoru Uemura, Masakazu Miyake, Michihiko Miyazaki, Masataka Ikeda, Mitsugu Sekimoto
Situs inversus totalis (SIT) is a rare anatomic anomaly in which organs in the chest and abdomen exist in a mirror image reversal of their normal positions. SIT can complicate surgical procedures, and few reports have described laparoscopic surgery for colorectal cancer in patients with SIT. Here, we report a case of successful laparoscopic surgery in a patient with SIT and sigmoid colon cancer. Laparoscopic sigmoidectomy involved colonic mobilization with high ligation of the inferior mesenteric vessels and complete mesocolic excision...
March 30, 2018: Asian Journal of Endoscopic Surgery
Yurong Jiao, Jinjie He, Jun Li, Dong Xu, Kefeng Ding
Vessel identification and dissection are the key processes of laparoscopic complete mesocolic excision (CME). Vascular injury will lead to complications such as prolonged operative time, intraoperative hemorrhage and ischemia of anastomotic stoma. Superior mesenteric artery (SMA), superior mesenteric vein(SMV), gastrointestinal trunk, left colic artery(LCA), sigmoid artery and marginal vessels in the mesentery have been found with possibility of heteromorphosis, which requires better operative techniques. Surgeons should recognize those vessel heteromorphosis carefully during operations and adjust strategies to avoid intraoperative hemorrhage...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Takaaki Osawa, Shunichiro Komatsu, Seiji Ishiguro, Tsuyoshi Sano
PURPOSE: Knowledge of mesenteric venous anatomy is important to safely perform laparoscopic complete mesocolic excision (CME) of the right colon. Despite their previously reported diversity, consistent features of the right colonic and pancreatic veins can be discerned. The objective of this study was to evaluate anatomical consistency of the right colic vein (RCV) and the pancreaticoduodenal vein associated with the colic vein (PDV-C). METHODS: This study included 125 consecutive patients undergoing contrast-enhanced multidetector-row CT of the abdomen...
April 2018: Surgical and Radiologic Anatomy: SRA
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