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<p>Hohenberger et al. described the complete mesocolic excision (CME)-central vascular ligation (CVL) technique for treating colon cancer and showed that it decreases the local recurrence rate and improves survival. With the advent of minimally invasive techniques, laparoscopic approach to CME with CVL is the natural consequence in the evolution of this procedure. This was a prospective study involving patients who underwent elective laparoscopic right hemicolectomy with CME-CVL compared with those who underwent the conventional technique between January 2019 and January 2024.The data regarding the patient demographics, operative details and postoperative outcomes, were obtained from our computerised database. One fifty five patients (median age 45&#xa0;years; men = 83, women = 72) were operated. Mean duration of surgery was not significantly longer in CME- CVL group compared to the conventional group (200 SD 53.07&#xa0;min vs. 164.25 SD 53.44&#xa0;min; p = 0.34). Patients with CME-CVL technique had comparative intra-operative technical difficulties in the form of need for extra port (10/82 vs. 8/73) and higher mean intra-operative blood loss (86.3 SD 26.5&#xa0;ml vs. 60.5 SD 19.8&#xa0;ml; p = 0.51). Post-operative morbidity was similar in both groups. Lymph node harvest in the final histopathology was significantly more ( 34 vs 17; p = 0.01) in the CME-CVL compared with the conventional group. Duration of hospital was comparable in both groups. There was no postoperative mortality. The concept of CME-CVL is a significant development in the management of colorectal cancer. Advantages of minimally invasive surgery have already been shown. Laparoscopic CME is a promising, safe, feasible, and standard method for right-sided colon cancer.</p>

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Laparoscopic D2 Plus (D2 +) Right Hemicolectomy with Complete Mesocolic Excision and Central Vascular Ligation—Technical Experience from a High-Volume Tertiary Care Centre

  • 期刊论文

  • 发表日期：

    2025年3月3日

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  • Pinak Dasgupta,
  • Ajay Pai,
  • Asokan S,
  • Palanivelu C

摘要

Hohenberger et al. described the complete mesocolic excision (CME)-central vascular ligation (CVL) technique for treating colon cancer and showed that it decreases the local recurrence rate and improves survival. With the advent of minimally invasive techniques, laparoscopic approach to CME with CVL is the natural consequence in the evolution of this procedure. This was a prospective study involving patients who underwent elective laparoscopic right hemicolectomy with CME-CVL compared with those who underwent the conventional technique between January 2019 and January 2024.The data regarding the patient demographics, operative details and postoperative outcomes, were obtained from our computerised database. One fifty five patients (median age 45 years; men = 83, women = 72) were operated. Mean duration of surgery was not significantly longer in CME- CVL group compared to the conventional group (200 SD 53.07 min vs. 164.25 SD 53.44 min; p = 0.34). Patients with CME-CVL technique had comparative intra-operative technical difficulties in the form of need for extra port (10/82 vs. 8/73) and higher mean intra-operative blood loss (86.3 SD 26.5 ml vs. 60.5 SD 19.8 ml; p = 0.51). Post-operative morbidity was similar in both groups. Lymph node harvest in the final histopathology was significantly more ( 34 vs 17; p = 0.01) in the CME-CVL compared with the conventional group. Duration of hospital was comparable in both groups. There was no postoperative mortality. The concept of CME-CVL is a significant development in the management of colorectal cancer. Advantages of minimally invasive surgery have already been shown. Laparoscopic CME is a promising, safe, feasible, and standard method for right-sided colon cancer.