Complete mesocolic excision (CME) with central vascular ligation (CVL) involves sharp dissection through the embryological planes. However, it may be associated with high mortalities and morbidities especially in colorectal emergencies. This study aimed to investigate the outcomes of CME with CVL in complicated colorectal cancers (CRCs). This was a retrospective study of emergency CRC resection in a tertiary center between March 2016 and November 2018. A total of 46 patients, with a mean age of 51 years, underwent an emergency colectomy for cancer (males, 26 [56.5%]; females, 20 [43.5%]). CME with CVL was performed for all patients. The mean operative time and blood loss were 188 min and 397 mL, respectively. Only five (10.8%) patients presented with burst abdomen, whereas only three (6.5%) presented with anastomotic leakage. The mean length of vascular tie was 8.7 cm, and the mean number of harvested lymph nodes (LNs) was 21.2. Emergency CME with CVL is a safe and feasible technique when performed by a colorectal surgeon and will result in obtaining a superior specimen with a large number of LNs.
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http://dx.doi.org/10.1007/s13193-022-01673-w | DOI Listing |
Eur J Surg Oncol
January 2025
UCD Centre of Precision Surgery, 47 Eccles Street, Dublin 7, Ireland; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland. Electronic address:
tumour specific surgery in colon cancer is gaining popularity among colorectal surgeons. Many advocate adapting surgical technique based on preoperative CT staging as not all patients require complete mesocolic excision (CME) and D3 lymphadenectomy. We aimed to assess the sensitivity and specificity of preoperative CT scans in nodal staging and analyse whether inadequate CT staging could have influenced local recurrences.
View Article and Find Full Text PDFCancers (Basel)
August 2024
Clinical Trial and Biostatistics, Research and Development Unit, University Hospital of Ferrara, 44121 Ferrara, Italy.
World J Surg Oncol
August 2024
Colorectal Surgery Unit, Concord Hospital, Concord, NSW, 2139, Australia.
Background: Ex vivo tissue morphometric (TM) measurements have been proposed as a quality marker for colorectal cancer (CRC) surgery. However, their survival associations require clarification. This study aimed to evaluate the feasibility of capturing TM measurements based on ex vivo fresh specimen images and explore the association between these TM measurements and survival outcomes.
View Article and Find Full Text PDFEur J Surg Oncol
November 2024
UCD Centre for Precision Surgery, University College Dublin, Ireland; Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland. Electronic address:
Introduction: Laparoscopic Complete Mesocolic Excision (CME) with Central Vascular Ligation (CVL) in colon cancer surgery has not been broadly adopted in part because of safety concerns. Pre-operative 3-D virtual modelling (3DVM) may help but needs validation.
Methods: 3DVM were routinely constructed from CT mesenteric angiograms (CTMA) using a commercial service (Visible Patient, Strasbourg, France) for consecutive patients during our CMECVL learning curve over three years.
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