Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?

손경모; 이인영; 이윤석; 계봉현; Cho Hyeon Min; 장제호; 김창남; 이길연; 이석환; 김준기; The Korean Laparoscopic Colorectal Surgery Study Group

doi:10.3393/ac.2021.00955.0136

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자료유형: 학술저널

저자정보: 손경모 (부산대학교) 이인영 (Department of Surgery Pusan National University Yangsan Hospital) 이윤석 (Department of Surgery Seoul St. Mary’s Hospital The Catholic University of Korea) 계봉현 (가톨릭대학교) Cho Hyeon Min (St. Vincent Hospital) 장제호 (을지대학교) 김창남 (을지대학교) 이길연 (경희의료원) 이석환 (Department of Surgery, Kyung Hee University Hospital at Gangdong) 김준기 (가톨릭대학교) The Korean Laparoscopic Colorectal Surgery Study Group (The Korean Laparoscopic Colorectal Surgery Study Group)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.37 No.6

발행연도: 2021.12

수록면: 434 - 444 (11page)

DOI: 10.3393/ac.2021.00955.0136

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Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

#Colonic neoplasms #Colectomy #Mesocolon #Laparoscopy #Lymph node excision

참고문헌 (85)

참고문헌 신청

허혁 / 2018 / Characteristics and Survival of Korean Patients With Colorectal Cancer Based on Data From the Korea Central Cancer Registry Data / Annals of Coloproctolgy 34(4):212~221

박선진 / 2020 / Laparoscopic Surgery for Colorectal Cancer in Korea: Nationwide Data from 2013 to 2018 / Cancer Research and Treatment 52(3):938~944

André T / 2009 / Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial / J Clin Oncol 27:3109~3116

MacFarlane JK / 1993 / Mesorectal excision for rectal cancer / Lancet 341:457~460

Hohenberger W / 2009 / Standardized surgery for colonic cancer: complete mesocolic excision and central ligation: technical notes and outcome / Colorectal Dis 11:354~365

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