Complete mesocolic excision and central vascular ligation in colon cancer surgery . anatomy principles and surgical technique

COMPLETE MESOCOLIC EXCISION AND CENTRAL VASCULAR LIGATION IN COLON CANCER SURGERY. ANATOMY PRINCIPLES AND SURGICAL TECHNIQUE (Abstract): Colon cancer continues to be a real public health problem despite recent advances. Surgery in colon cancer patients remains the only curative treatment, hence the importance of an adequate techniqual approach. Heald introduced, in 1982, the total mesorectum excision technique for rectal cancer patients, with susequent improvement in oncologic results and reduced recurrence rates. Thus, total mesorectum excision technique represents today the gold standard in surgical resection of rectal malignancies. Based on this results, Hohenbergen first applied in 2007 the total mesorectum excision principle in colon cancer surgery as complete mesocolon excision (ECM) and central vascular ligation (CVL). Complete mesocolic excision is based on a correct identification of the dissection plan between the mesofascial plane and the retroperitoneal fascia, central vascular ligation of the vessels to remove vertical lymph nodes and resection of the affected colonic segment. This paper aims to follow the principle of ECM and LVC in classic surgery and to correctly identify the anatomical dissection plans. In conclusion, applying the principles of CME and CVL in colon cancer surgery can improve cancer outcomes without increasing the incidence of postoperative complications.