Comparative Evaluation of Complete Mesocolic Excision Versus Conventional Right Hemicolectomy in Right-Sided Colon
Dhanalakshmi Kadirvel1, Srinath Ganesan2, Ilango Parthasarathy3
1General Surgery, Sree Balaji Medical College & Hospital, Chennai, IND.
None:
Background Complete mesocolic excision (CME) with central vascular ligation (CVL) has emerged as an advanced surgical technique aiming to improve oncological outcomes in right-sided colon cancer. This study aims to compare the surgical and short-term oncological outcomes between CME and conventional right hemicolectomy (CON) performed in a tertiary care center. Methods A retrospective observational study was conducted between January 2021 and December 2024 in Sree Balaji Medical College & Hospital, a high-volume tertiary care center in Chennai, India, including 180 patients with right-sided colon cancer. Patients were categorized into two groups based on the surgical technique: CME (n = 94) and CON (n = 86). Parameters assessed included lymph node harvest, operative time, postoperative complications, type of anastomosis (intracorporeal vs. extracorporeal), and stapling technique (Barcelona vs. standard). Statistical analysis was performed using IBM SPSS Statistics, with a significance threshold set at p < 0.05. Results The CME group exhibited a significantly higher lymph node yield (≥12 nodes in 94.7% vs. 79.1%, p < 0.001) and increased adoption of intracorporeal anastomosis (44.7% vs. 14.0%, p = 0.001) and Barcelona stapling technique (35.1% vs. 4.7%, p < 0.001). Operative time was longer for CME (156 ± 47 minutes vs. 112 ± 35 minutes), although postoperative morbidity rates were comparable between groups. Conclusion CME with CVL offers superior lymph node harvest and facilitates minimally invasive anastomotic techniques without increasing postoperative complications. It should be considered the standard of care in experienced centers.
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