Vecchio Rosario, Intagliata Eva, Marchese Salvatore, Catalano Renato
Ann Ital Chir. 2018;89:217-222.
Nowadays, there is no standardization in surgical procedures for treatment of colon cancer. Since its introduction, laparoscopic surgery has gained increasing interest in colorectal surgery and it is now performed worldwide for treatment of colon cancer. Following the concept of total mesocolic excision introduced by Heald in 1988 in order to reduce local recurrence after surgical treatment of mid/low rectal tumors, the idea of complete removal of the mesocolon mesocolic envelope has been developed also for colon cancer, has evolved longtime and complete mesocolic excision has been recently adopted as the optimal approach for colon cancer. However, complete mesocolic excision, whose purpose is to remove all lymphatics and lymph nodes draining the tumor, is still discussed as far as oncologic results are concerned. Moreover, the role of laparoscopic approach for complete removal of mesocolon has to be defined.
Selection of studies. A MEDLINE-PubMed database search of the current English Literature was performed using the terms: complete mesocolic excision; high vascular ligation; splenic flexure mobilization.
The inclusion criteria were report on CME for colonic cancer with high vascular ligation; minimum number of patients included (20 patients). Two independent reviewers (CRS, IE) extracted the data.
In this article, an update from the Literature on results of complete mesocolic excision was undertaken and data have been discussed. The role of laparoscopic complete mesocolic excision in colon cancer patients has been focused, and it seems to be safe and feasible, it should be standardized and hypothetical oncologic advantages should be expected.
Colorectal-tumor, Complete mesocolic excision, High vascular ligation, Laparoscopic colorectal surgery, Splenic flexure mobilization, Total mesocolic excision.
目前，结肠癌的外科治疗手术尚无标准化方案。自腹腔镜手术引入以来，其在结直肠外科领域受到越来越多的关注，目前已在全球范围内用于结肠癌的治疗。继1988年希尔德提出全结肠系膜切除术的概念以降低中低位直肠癌手术治疗后的局部复发率之后，全结肠系膜完整切除的理念也已应用于结肠癌治疗，并且经过长期发展，全结肠系膜切除术最近已被采纳为结肠癌的最佳治疗方法。然而，就肿瘤学结果而言，旨在切除肿瘤所有引流淋巴管和淋巴结的全结肠系膜切除术仍存在争议。此外，腹腔镜手术在完整切除结肠系膜中的作用也有待明确。
研究选择。使用以下术语在MEDLINE-PubMed数据库中检索当前英文文献：全结肠系膜切除术；高位血管结扎；脾曲游离。
纳入标准为关于结肠癌全结肠系膜切除术并进行高位血管结扎的报告；纳入患者的最小数量（20例患者）。两名独立的审阅者（CRS、IE）提取数据。
本文对全结肠系膜切除术结果的文献进行了更新，并对数据进行了讨论。重点关注了腹腔镜全结肠系膜切除术在结肠癌患者中的作用，其似乎是安全可行的，应进行标准化，并且有望获得假设的肿瘤学优势。
结直肠肿瘤；全结肠系膜切除术；高位血管结扎；腹腔镜结直肠手术；脾曲游离；全结肠系膜切除术
