Abstract YO11
Case summary
Background: The concept of complete mesocolic excision (CME) was introduced by Hohenberger in 2009 and has been implemented recently by many centers for colon cancer, focusing on the embryonic plane of the mesocolon. We aimed to evaluate some short-term results of laparoscopic CME and analyze colon specimens to determine lymph node (LN) metastasis distribution and status according to each tumor location after using the GEWF solution.
Methods: A prospective study was conducted on 67 patients from May 2021 to March 2024.
Results: The average age was 59.9 ± 14.9 years, with 53.7% male. pT2 and pT3 stages accounted for 47.8% and 40.3%, respectively, while 58.2% were pN0. Stage I (AJCC 8th edition) was most common at 43.3%, followed by stage IIIb at 26.9%. Surgical site infections (SSIs) occurred in 11.9% of cases. The mean operative time was 156.9 ± 39.7 minutes, with no major complications requiring reoperation and no short-term mortality. The average hospital stay was 7.2 ± 2.1 days. The mean specimen length was 30.6 ± 7.8 cm, mesenteric width 9.0 ± 1.5 cm, and tumor size 4.0 ± 1.7 cm. On average, 59.6 ± 22.9 lymph nodes were retrieved per patient. The surgical plane quality was 86.6% mesocolic and 13.4% intramesocolic. Of 3994 lymph nodes analyzed, 114 were metastatic, with two cases (3%) having metastasis at LN station 3.
Conclusions: Laparoscopic CME proved to be safe and feasible. The improved number of lymph node harvesting was achieved due to colectomy with complete mesocolic excision. Therefore, this technique increases the ability to detect positive regional lymph nodes, helping to diagnose the stage more accurately.