Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2015; 7(12): 383-388
Published online Dec 15, 2015. doi: 10.4251/wjgo.v7.i12.383
Complete mesocolic excision: Techniques and outcomes
Nikoletta Dimitriou, John Griniatsos
Nikoletta Dimitriou, John Griniatsos, 1st Department of Surgery, University of Athens, Medical School, Laiko Hospital, 11527 Athens, Greece
Author contributions: Dimitriou N drafted the manuscript and wrote the paper; Griniatsos J designed the study, corrected the manuscript and made the final approval.
Conflict-of-interest statement: Authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: John Griniatsos, Associate Professor of Surgery, 1st Department of Surgery, University of Athens, Medical School, Laiko Hospital, 17 Agiou Thoma str, GR 115-27, 11527 Athens, Greece. johngriniatsos@yahoo.com
Telephone: +30-210-7456855 Fax: +30-213-2061766
Received: June 1, 2015
Peer-review started: June 1, 2015
First decision: August 7, 2015
Revised: October 8, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 15, 2015
Processing time: 197 Days and 2.8 Hours
Abstract

Complete mesocolic excision (CME) for the treatment of colon cancer was first introduced in the West in 2008. The first aim of this procedure is to remove the afflicted colon and its accessory lymphovascular supply by resecting the colon and mesocolon in an intact envelope of visceral peritoneum, which holds potentially involved lymph nodes. The second component of CME is a central vascular tie to remove completely all lymph nodes in the central (vertical) direction. In its original iteration, CME was performed via laparotomy, although many centers preferentially perform laparoscopic surgery, with its associated benefits and similar oncological outcomes, as the standard treatment for colonic cancer. Here, we present the surgical techniques for CME in open and laparoscopic surgery, as well as the surgical, pathological and oncological outcomes of the procedure that are available to date. Because there are no randomized control trials comparing CME to “standard” colon surgery, the principles underlying CME seem anatomical and logical, and the results published from the Far East, reporting an 80% 5-year survival rate for Stage III cancer, should guide us.

Keywords: Colon cancer; Complete mesocolic excision; Laparotomy; Laparoscopic colectomy; Surgical technique; Oncological outcome

Core tip: This review presents the most recent knowledge in the field of complete mesocolic excision (CME) for colon cancer treatment and provides key points in both open and laparoscopic surgical techniques, surgical and pathological outcomes, and oncological outcomes of the procedure. The conclusion makes clear that in the absence of randomized control trials comparing CME to “standard” colon surgery, the principles underlying CME seem anatomical and logical, and the favorable long-term results published from the Far East for Stage III colon cancer disease should guide us in the future.