Valentina Ferri1, Emilio Vicente2, Yolanda Quijano2, Hipolito Duran2, Eduardo Diaz2, Isabel Fabra2, Luis Malave2, Ruben Agresott2, Roberta Isernia3, Pablo Cardinal-Fernandez4, Pablo Ruiz2, Valentina Nola5, Giovanni de Nobili6, Benedetto Ielpo7, Riccardo Caruso2. 1. Division of General Surgery, Sanchinarro Hospital, San Pablo University, Calle Oña 10, 28050, Madrid, Spain. valenpeglio@gmail.com. 2. Division of General Surgery, Sanchinarro Hospital, San Pablo University, Calle Oña 10, 28050, Madrid, Spain. 3. General Surgery, University of Bari, Madrid, Spain. 4. Intensive Care Unit, Hospital Universitario HM Sanchinarro, Madrid, Spain. 5. General Surgery, Universita degli Studi di Pavia, Madrid, Spain. 6. General Surgery, Università degli Studi Gabriele d'Annunzio Chieti Pescara Dipartimento di Scienze, Madrid, Spain. 7. General Surgery, Hospital del Mar, Madrid, Spain.
Abstract
BACKGROUND: This meta-analysis aims to investigate the role of complete mesocolic excision (CME) in the treatment of right-side colon cancer when compared with standard right-side hemicolectomy, focusing on oncological outcomes, mortality and morbidity rates. MATERIALS AND METHODS: A systematic literature search was performed on MEDLINE and EMBASE archives, including studies on CME in right-side colon cancer. Primary outcomes were five-year disease-free survival and five-year overall survival. Secondary outcomes investigated were mortality and morbidity rates, intraoperative blood loss, anastomotic leakage, postoperative ileus, day of postoperative flatus, pulmonary infection, duration of hospital stay and number of lymph nodes harvested. RESULTS: Seventeen studies have been included in this meta-analysis for a total of 3918 patients. The five-year disease-free survival (DFS) and overall survival (OS) results improved in the CME group with respect to conventional right-side colectomy with an OR 1.88 (95% CI 1.02-3.45) and OR 2.77 (95% CI 1.33-5.74), respectively. The incidence of mortality and morbidity was comparable between the two groups. Moreover, conventional surgery time was faster than CME (MD 33.69 min, 95% CI 12.79-54.59), while no significant differences were reported in mean blood loss and hospital stay. Furthermore, the CME group showed a higher mean number of harvested lymph nodes (MD 7.08 lymph nodes 95% CI 4.90-9.27). CONCLUSION: Complete mesocolic excision of the right-side colectomy improves oncological outcomes without increasing mortality and morbidity rates compared to standard right-side hemicolectomy. CME should therefore be routinely performed in the treatment of right-side colon cancer.
BACKGROUND: This meta-analysis aims to investigate the role of complete mesocolic excision (CME) in the treatment of right-side colon cancer when compared with standard right-side hemicolectomy, focusing on oncological outcomes, mortality and morbidity rates. MATERIALS AND METHODS: A systematic literature search was performed on MEDLINE and EMBASE archives, including studies on CME in right-side colon cancer. Primary outcomes were five-year disease-free survival and five-year overall survival. Secondary outcomes investigated were mortality and morbidity rates, intraoperative blood loss, anastomotic leakage, postoperative ileus, day of postoperative flatus, pulmonary infection, duration of hospital stay and number of lymph nodes harvested. RESULTS: Seventeen studies have been included in this meta-analysis for a total of 3918 patients. The five-year disease-free survival (DFS) and overall survival (OS) results improved in the CME group with respect to conventional right-side colectomy with an OR 1.88 (95% CI 1.02-3.45) and OR 2.77 (95% CI 1.33-5.74), respectively. The incidence of mortality and morbidity was comparable between the two groups. Moreover, conventional surgery time was faster than CME (MD 33.69 min, 95% CI 12.79-54.59), while no significant differences were reported in mean blood loss and hospital stay. Furthermore, the CME group showed a higher mean number of harvested lymph nodes (MD 7.08 lymph nodes 95% CI 4.90-9.27). CONCLUSION: Complete mesocolic excision of the right-side colectomy improves oncological outcomes without increasing mortality and morbidity rates compared to standard right-side hemicolectomy. CME should therefore be routinely performed in the treatment of right-side colon cancer.
Authors: Joseph C Kong; Swetha Prabhakaran; Kay T Choy; José T Larach; Alexander Heriot; Satish K Warrier Journal: ANZ J Surg Date: 2021-01-05 Impact factor: 1.872
Authors: Giuseppe S Sica; Danilo Vinci; Leandro Siragusa; Bruno Sensi; Andrea M Guida; Vittoria Bellato; Álvaro García-Granero; Gianluca Pellino Journal: Surg Endosc Date: 2022-09-12 Impact factor: 3.453
Authors: M Franceschilli; D Vinci; S Di Carlo; B Sensi; L Siragusa; A Guida; P Rossi; V Bellato; R Caronna; S Sibio Journal: Discov Oncol Date: 2021-08-06