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Caudal-to-Cranial Approach for Right Colectomy with Complete Mesocolic Excision in Colon Cancer: A Systematic Review
Mohamed Maatouk1, Yacine Ben Safta2, Ghassen Hamdi Kbir3
1A21 Surgery Department, Faculty of Medicine of Tunis, Charles Nicolle Hospital, Tunis El Manar University, Rue 9 Avril, 1007, Tunis, Bab Saadoun, Tunisia. maatouk.m@yahoo.com.
Journal of Gastrointestinal Cancer
|December 20, 2022
Summary
The caudal-to-cranial approach (CCA) with complete mesenteric excision (CME) appears safe and feasible for right colectomy in colon cancer patients. Further research is needed to confirm these findings.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Right colectomy is a common procedure for right colon cancer.
- The caudal-to-cranial approach (CCA) with complete mesenteric excision (CME) is an emerging surgical technique.
- Limited evidence exists on the safety and efficacy of CCA.
Approach:
- A systematic review evaluated short- and long-term outcomes of CCA.
- Methodological quality and risk of bias were assessed.
- Meta-analyses compared CCA with other surgical techniques.
Key Points:
- Six studies (2017-2021) involving 594 patients were reviewed.
- Postoperative complications and oncological outcomes were acceptable.
- Meta-analysis showed no significant differences between CCA and medial-to-lateral approaches in operative time, hospital stay, morbidity, or lymph node yield.
Conclusions:
- CCA with CME may be a feasible and safe option for right-sided colon cancer.
- Methodological limitations and lack of randomized controlled trials necessitate cautious interpretation.
- Further high-quality studies are required to validate these preliminary findings.
