Debove Clotilde, Lefèvre Jérémie H, Parc Yann
Hôpital Saint-Antoine, service de chirurgie générale et digestive, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France; Pierre & Marie Curie, université Paris VI, faculté de médecine, Paris, France.
Hôpital Saint-Antoine, service de chirurgie générale et digestive, 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12, France; Pierre & Marie Curie, université Paris VI, faculté de médecine, Paris, France.
Bull Cancer. 2017 Feb;104(2):177-181. doi: 10.1016/j.bulcan.2016.11.004. Epub 2016 Nov 29.
On the same principle than total mesorectal excision in rectal cancer, the effect of complete mesocolic excision on short and long-term outcomes is actually evaluated for colonic adenocarcinoma. This method, usually performed for left colectomy, offers a surgical specimen of higher quality, with a larger number of lymph nodes harvested. For right colectomy, surgical specifications make it less common complete mesocolic excision and conventional surgery offer comparable outcomes, as regards to postoperative morbidity and mortality rates. No differences are identified between laparoscopic and open surgery. On oncologic outcomes, only two studies report a higher free-disease survival after complete mesocolic excision. Then, there is evidence that complete mesocolic excision offers a higher rate of specimen with extensive lymph node resection, without increased morbidity rate. However, there is limited evidence that it leads to improve long-term oncological outcomes.
基于与直肠癌全直肠系膜切除相同的原则，目前正在评估完整结肠系膜切除对结肠腺癌短期和长期预后的影响。这种方法通常用于左半结肠切除术，能提供质量更高的手术标本，获取的淋巴结数量更多。对于右半结肠切除术，由于手术特点，完整结肠系膜切除不太常用，传统手术在术后发病率和死亡率方面能提供相似的结果。腹腔镜手术和开放手术之间未发现差异。在肿瘤学预后方面，仅有两项研究报告称完整结肠系膜切除术后无病生存率更高。因此，有证据表明完整结肠系膜切除能提供更高比例的具有广泛淋巴结切除的标本，且发病率未增加。然而，仅有有限的证据表明它能改善长期肿瘤学预后。
