Siani LM, Garulli G. Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer: A comprehensive review. World J Gastrointest Surg 2016; 8(2): 106-114 [PMID: 26981184 DOI: 10.4240/wjgs.v8.i2.106]
Corresponding Author of This Article
Luca Maria Siani, MD, PhD, Minimally Invasive General and Thoracic Surgery Unit, Azienda Unità Sanitaria Locale della Romagna - “Ceccarini Hospital”, Via Frosinone, 1, 47838 Riccione, Italy. lucamaria.siani@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Topic Highlight
Open-Access Policy of This Article
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/
World J Gastrointest Surg. Feb 27, 2016; 8(2): 106-114 Published online Feb 27, 2016. doi: 10.4240/wjgs.v8.i2.106
Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer: A comprehensive review
Luca Maria Siani, Gianluca Garulli
Luca Maria Siani, Gianluca Garulli, Minimally Invasive General and Thoracic Surgery Unit, Azienda Unità Sanitaria Locale della Romagna - “Ceccarini Hospital”, 47838 Riccione, Italy
Author contributions: Siani LM contributed to study conception and design, and writed manuscript; Garulli G contributed to study conception and design.
Conflict-of-interest statement: The authors declare non conflict of interest or any financial support.
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: Luca Maria Siani, MD, PhD, Minimally Invasive General and Thoracic Surgery Unit, Azienda Unità Sanitaria Locale della Romagna - “Ceccarini Hospital”, Via Frosinone, 1, 47838 Riccione, Italy. lucamaria.siani@gmail.com
Telephone: +39-348-4731768 Fax: +39-06-45448165
Received: April 27, 2015 Peer-review started: April 29, 2015 First decision: August 31, 2015 Revised: December 4, 2015 Accepted: December 13, 2015 Article in press: December 14, 2015 Published online: February 27, 2016 Processing time: 306 Days and 22.1 Hours
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.
