Laparoscopic complete mesocolic excision (CME) for colon cancer: study design and preliminary outcome from an randomized controlled trial NCT01628250

Bo Feng, MD, Aiguo Lu, MD, Mingliang Wang, MD, Junjun Ma, MD, Minhua Zheng, MD

Surgery Department of Ruijin Hospital, Shanghai Minimally Invasive Surgery Center,Shanghai Jiaotong University School of Medicine

Background and Objective With the standardization of total mesorectal excision (TME), outcome of rectal cancer surgery was significantly improved. Recently, Hohenberger demonstrated a novel concept, complete mesocolic excision (CME), for colon cancer surgery, which is associated with a better 5-year overall survival. It is suggested that CME might be a standard surgery for colon cancer. Laparoscopic complete mesocolic excision(LCME) is a concept that using laparoscopic surgery technique to perform a resection for colon cancer. Besides, the segment of the colon containing the tumor, the resection area should include an intact mesocolon as an envelope to encase the possible route for metastasis. The routes include blood vessels, lymphatic drain and etc. Such hypothesis predicts better histopathological and higher oncological results which turns into better survival rate and better quality of life. The aim of this study was to compare the clinical results of LCME and D3-laparoscopic colectomy(L-D3) for colon cancer.

Design It was a randomized controlled trial. The primary outcome measures: Histopathological outcomes obtained through the surgeries.The contents of histopathological outcomes are obtained from the surgeries, including the tissue morphometry; number of lymph nodes retrieved; and the plane of the resected mesocolon. The secondary outcome measures: Oncological result and 3-year survival rate.

Results There were 20 cases and 19 cases in the LCME group and L-D3 group, respectively. All the 20 cases were successfully performed laparoscopic CME and the 19 specimens were evaluated pathologically as mesocolic plane,which is more than that in the L-D3 group. The total number of lymph nodes removed in LCME group was significantly higher than that of the L-D3 group. No significant diffetence was found in terms of the median operation time, median time for passage of flatus and hospitalization and complications between the two groups.

Conclusions Laparoscopic CME with medial access is technically feasible and might become the standardized procedure for colon cancer.

Session: Podium Presentation

Program Number: S075

« Return to SAGES 2013 abstract archive