Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer: A comprehensive review

Core Tip

Core tip: Laparoscopic complete mesocolic excision (CME) with central vascular ligation (CVL) is based on resection of the colon within its intact and inviolate mesocolon with high tie ligation, so to improve the quality of the resection specimen produced; up-to-date anatomo-embryological concepts are analyzed in detail, focusing on the latest studies of the mesenteric organ, its dissection by mesofascial and retrofascial cleavage planes, and questioning the need for a new terminology in colonic resections. The rationale behind the CME with CVL is explained and particular attention is paid to the current surgical techniques. The impact on local recurrence, disease-free and overall survival is reviewed. Current literature about laparoscopic CME with CVL demonstrated better quality of the surgical specimen produced and significant survival advantage when compared to standard non-mesocolic resections, stressing the importance of meso-resectional surgery, especially when performed with minimally invasive techniques: higher surgical quality, faster recovery and better immunological response may in fact contribute to better long term oncologic outcome.