Related Experiment Video
Updated: Aug 16, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
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.
Background:
A newly emerging approach "caudal to cranial" with complete mesenteric excision (CME) has recently been proposed for right colectomy in patients with right colon cancer. To date, only a few studies about this approach have appeared. Our study aims to investigate the safety and efficacy of this new technique.
Methods:
A systematic review of the literature was conducted to evaluate the evidence regarding short- and long-term outcomes after the caudal-to-cranial approach (CCA). Methodological Index for Non-Randomized Studies was used to evaluate methodological quality. The risk of bias was assessed using Robvis tool. Meta-analyses have been conducted for the outcomes of studies comparing CCA with other techniques.
Results:
We found six studies from 2017 to 2021 with a total of 594 patients. The postoperative complications and oncological outcomes were acceptable. Two studies comparing CCA to medial-to-lateral approach were included in the meta-analysis. No differences were found between the techniques regarding to operative time, length of hospital stay, overall morbidity, and number of lymph nodes.
Conclusion:
Although the interpretation of our findings may be restrained by methodological limitations, risk of bias, and the absence of well-designed randomized controlled trials, CCA with CME in right-sided colon cancer may be a feasible and safe procedure.
