医療インプラントと外科

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Complete Mesocolic Excision and Central Vascular Ligation in Colon Cancer Surgery, Feasibility and Outcome

Mohamed Ibrahim, MD

Background: Colon cancer continues to be a major
health problem worldwide. Being the third most common
type of cancer in men and the second in women.
Standard treatment of colon cancer is based on surgical
resection. An adequate number of lymph nodes harvested
are important for a correct stabilization of the disease;
thereby the extension of the colonic resection remains
controversial. Complete mesocolic excision (CME) with
central vascular ligation (CVL) has recently been found
to improve oncological outcomes in patient with colonic
cancer. Complete mesocolic excision is based on a correct
identification of the dissection plan between the mesofascial
plane and the retroperitoneal fascia, central vascular
ligation of the vessels to remove vertical lymph nodes
and resection of the affected colonic segment. Methods:
This is a prospective study done at general surgery department
of Fayoum University hospitals from January
2015 to January 2019 including 60 patients with operable
colonic cancer operated with adequate surgical margin,
complete mesocolic excision and high vascular ligation.
Results: The number of dissected lymph node was 27.7
± 4.2 and this number is more than that dissected in the
conventional colectomy mentioned in many studies in literature,
more over larger mesocolon area, longer distance
from vascular high ligation point to intestinal wall, and
longer distance from vascular high ligation point to tumor
center were observed. Conclusion: Surgery in colon
cancer patients remains the only curative treatment and
applying the principles of complete mesocolic excision
and central vascular ligation in colon cancer surgery can
improve cancer outcomes without increase the incidence
of postoperative complications..