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Ann Surg: Compared with standard total mesocolectomy, expanded total mesocolectomy may do more harm than good for sigmoid colon cancer!

 Last Update: 2021-09-11
 Source: Internet
 Author: User

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Although 25% of colorectal cancers affect the sigmoid colon, the optimal scope of colectomy (sigmoid colectomy vs.

Colorectal cancer

In the sigmoid colon and upper colorectal cancer surgery, resection of a standard full mesocolon (s-CME) will sweep inferior mesenteric lymphoid tissue surrounding the artery (the IMA), but not the cleaning lymphoid tissue surrounding the fat part of the inferior mesenteric vein

Expanded total mesenteric resection (e-CME) for colon cancer is based on s-CME.

Schematic diagram of e-CME and s-CME ( s-CME: green marking range ; e-CME: s-CME+ yellow marking range )

Schematic diagram of e-CME and s-CME ( s-CME: green marking range ; e-CME: s-CME+ yellow marking range ) s-CME: green marking range e-CME: s-CME+ yellow marking range

The purpose of this study was to evaluate whether extended total mesocolonectomy (e-CME) for sigmoid colon cancer can improve the clinical prognosis of patients without affecting the morbidity or functional outcome

This is a single-blind randomized study that recruited sigmoid colon patients from 4 medical centers and randomly assigned them to e-CME or s-CME groups

Disease-free survival and overall survival of the two groups

A total of 93 patients were analyzed: 46 e-CME and 47 s-CME

The perioperative results of the two groups were similar.

Male patients have poor recovery of urinary function and sexual function after e-CME treatment Male patients have poor recovery of urinary function and sexual function after e-CME treatment

In summary, the expansion of lymph node dissection to include the IMV area did not increase the number of lymph nodes removed, nor did it improve the local recurrence rate or survival rate of patients with sigmoid colon cancer

IMV region include extended lymph node dissection and lymphadenectomy out without increasing the number of colon cancer patients is not improved the survival rate of local recurrence or include IMV extended lymph node dissection area and without increasing the number of the lymph node dissection, no improvement Local recurrence or survival rate of patients with sigmoid colon cancer

Original source:

Planellas P,Marinello F,Elorza G et al.

Extended Versus Standard Complete Mesocolon Excision in Sigmoid Colon Cancer: A Multicentre Randomised Controlled Trial

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