Comparison of conventional right colectomy and complete mesocolic excision technique-case-control analysis of short-term results

IntroductionThe long-term oncologic advantages of complete mesocolic excision (CME) with central vascular ligation and extended lymphadenectomy in right-sided colon cancer have been emphasized in several studies, without compromise of perioperative morbidity or mortality; however, prospective randomized data are scarce.MethodsWe performed a single-center non-randomized case-control study comparing conventional non-CME right colectomies (nCME) and complete mesocolic excision (CME) procedures during the period from January 2019 to December 2020. Perioperative morbidity, length of hospital stay (LOHS), operative time, and lymph node yield were analyzed.ResultsA total of 131 patients underwent surgery for right-sided colon cancer, with 28 (21%) in the CME group and 103 (79%) in the conventional group. Operative time was significantly longer in the CME group (p < 0.001) compared to conventional procedures. The duration of hospitalization was statistically similar (p = 0.226), no difference was observed in 30-day morbidity (p = 0.166), and the majority of complications in both groups were grades 0-2 (CME: 82%; nCME: 91%). There were no 30-day mortalities. The lymph node yield in CME was significantly higher compared to the conventional surgery (p = 0.041).ConclusionComplete mesocolic excision (CME) for right-sided colon cancer is safe without increasing complications or hospital stay, with an acceptable increase in operative time. The significant increase in lymph node yield enables better staging and may lead to improved long-term oncologic outcomes.

Automated summary

Comparing to conventional procedures, studies have shown that complete mesocolic excision (CME) for right-sided colon cancer has long-term oncologic advantages without increasing perioperative morbidity or mortality.