Abstract
Background: It has been evident for a while that the result after resection for colon cancer may not have been optimal. Several years ago, this was showed by some leading surgeons in the USA but a concept of improving results was not consistently pursued. Later, surgeons in Europe and Japan have increasingly adopted the more radical principle of complete mesocolic excision (CME) as the optimal approach for colon cancer. The concept of CME is a similar philosophy to that of total mesorectal excision for rectal cancer and precise terminology and optimal surgery are key factors. Method: There are three essential components to CME. The main component involves a dissection between the mesenteric plane and the parietal fascia and removal of the mesentery within a complete envelope of mesenteric fascia and visceral peritoneum that contains all lymph nodes draining the tumour area (Hohenberger et al., Colorectal Disease 11:354-365, 2009; West et al., J Clin Oncol 28:272-278, 2009). The second component is a central vascular tie to completely remove all lymph nodes in the central (vertical) direction. The third component is resection of an adequate length of bowel to remove involved pericolic lymph nodes in the longitudinal direction. Result: The oncological rationale for CME and various technical aspects of the surgical management will be explored. Conclusion: The consensus conference agreed that there are sound oncological hypotheses for a more radical approach than has been common up to now. However, this may not necessarily apply in early stages of the tumour stage. Laparoscopic resection appears to be equally well suited for resection as open surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 419-428 |
| Number of pages | 10 |
| Journal | International Journal of Colorectal Disease |
| Volume | 29 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2014 Jan 1 |
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Keywords
- Colon cancer
- Complete mesocolic excision
- Laparoscopy
- Lymph node metastasis
- Surgery
ASJC Scopus subject areas
- Gastroenterology
Cite this
The rationale behind complete mesocolic excision (CME) and a central vascular ligation for colon cancer in open and laparoscopic surgery : Proceedings of a consensus conference. / Søndenaa, K.; Quirke, P.; Hohenberger, W.; Sugihara, K.; Kobayashi, H.; Kessler, H.; Brown, G.; Tudyka, V.; D'Hoore, A.; Kennedy, R. H.; West, N. P.; Kim, Seon Hahn; Heald, R.; Storli, K. E.; Nesbakken, A.; Moran, B.
In: International Journal of Colorectal Disease, Vol. 29, No. 4, 01.01.2014, p. 419-428.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - The rationale behind complete mesocolic excision (CME) and a central vascular ligation for colon cancer in open and laparoscopic surgery
T2 - Proceedings of a consensus conference
AU - Søndenaa, K.
AU - Quirke, P.
AU - Hohenberger, W.
AU - Sugihara, K.
AU - Kobayashi, H.
AU - Kessler, H.
AU - Brown, G.
AU - Tudyka, V.
AU - D'Hoore, A.
AU - Kennedy, R. H.
AU - West, N. P.
AU - Kim, Seon Hahn
AU - Heald, R.
AU - Storli, K. E.
AU - Nesbakken, A.
AU - Moran, B.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Background: It has been evident for a while that the result after resection for colon cancer may not have been optimal. Several years ago, this was showed by some leading surgeons in the USA but a concept of improving results was not consistently pursued. Later, surgeons in Europe and Japan have increasingly adopted the more radical principle of complete mesocolic excision (CME) as the optimal approach for colon cancer. The concept of CME is a similar philosophy to that of total mesorectal excision for rectal cancer and precise terminology and optimal surgery are key factors. Method: There are three essential components to CME. The main component involves a dissection between the mesenteric plane and the parietal fascia and removal of the mesentery within a complete envelope of mesenteric fascia and visceral peritoneum that contains all lymph nodes draining the tumour area (Hohenberger et al., Colorectal Disease 11:354-365, 2009; West et al., J Clin Oncol 28:272-278, 2009). The second component is a central vascular tie to completely remove all lymph nodes in the central (vertical) direction. The third component is resection of an adequate length of bowel to remove involved pericolic lymph nodes in the longitudinal direction. Result: The oncological rationale for CME and various technical aspects of the surgical management will be explored. Conclusion: The consensus conference agreed that there are sound oncological hypotheses for a more radical approach than has been common up to now. However, this may not necessarily apply in early stages of the tumour stage. Laparoscopic resection appears to be equally well suited for resection as open surgery.
AB - Background: It has been evident for a while that the result after resection for colon cancer may not have been optimal. Several years ago, this was showed by some leading surgeons in the USA but a concept of improving results was not consistently pursued. Later, surgeons in Europe and Japan have increasingly adopted the more radical principle of complete mesocolic excision (CME) as the optimal approach for colon cancer. The concept of CME is a similar philosophy to that of total mesorectal excision for rectal cancer and precise terminology and optimal surgery are key factors. Method: There are three essential components to CME. The main component involves a dissection between the mesenteric plane and the parietal fascia and removal of the mesentery within a complete envelope of mesenteric fascia and visceral peritoneum that contains all lymph nodes draining the tumour area (Hohenberger et al., Colorectal Disease 11:354-365, 2009; West et al., J Clin Oncol 28:272-278, 2009). The second component is a central vascular tie to completely remove all lymph nodes in the central (vertical) direction. The third component is resection of an adequate length of bowel to remove involved pericolic lymph nodes in the longitudinal direction. Result: The oncological rationale for CME and various technical aspects of the surgical management will be explored. Conclusion: The consensus conference agreed that there are sound oncological hypotheses for a more radical approach than has been common up to now. However, this may not necessarily apply in early stages of the tumour stage. Laparoscopic resection appears to be equally well suited for resection as open surgery.
KW - Colon cancer
KW - Complete mesocolic excision
KW - Laparoscopy
KW - Lymph node metastasis
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84898596842&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84898596842&partnerID=8YFLogxK
U2 - 10.1007/s00384-013-1818-2
DO - 10.1007/s00384-013-1818-2
M3 - Review article
C2 - 24477788
AN - SCOPUS:84898596842
VL - 29
SP - 419
EP - 428
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
SN - 0179-1958
IS - 4
ER -