Is Complete Mesocolic Excision Technique Superior to Conventional Hemicolectomy Technique for Patients with Right-Sided Colon Cancer? Preliminary Findings from a Single-Center Retrospective Analysis

Amaç: Sağ kolon kanserinde tam mezokolik eksizyon ile standart hemikolektomi tekniklerinin cerrahi ve onkolojik sonuçlarını karşılaştırmak.Yöntem: Tam mezokolik eksizyon (n=48) ve standart teknik ile (n=39) sağ hemikolektomi yapılan toplam 87 evre 1-3 sağ kolon kanseri olgusu çalışmaya dahil edildi.Hastaların demografik yapıları, tümor özellikleri, yapılan tedaviler ve sonuçları gruplar arasında karşılaştırıldı.Bulgular: Gruplar arasında hasta, tümör ve kemoterapi tedavi özellikleri, cerrahi morbidite, nüks oranları ve apikal lenf nodu metastaz oranları açısından farklılık saptanmadı.Tam mezokolik eksizyon grubunda ortalama total lenf nodu sayısı (58,0 vs 31,0, p<0,001) ve apikal lenf nodu sayısı (3,0 vs 2,0, p=0,034) anlamlı olarak yüksek saptandı.Standart teknik grubunda apikal lenf nodu metastaz oranının anlamlı fark oluşturmasa da ABSTRACT ÖZ Aim: To evaluate the surgical and oncological outcomes of complete mesocolic excision versus conventional hemicolectomy in patients with rightsided colon cancer.Method: A total of 87 patients with stage I-III cancer disease who underwent conventional hemicolectomy (n=39) or complete mesocolic excision (n=48) in a tertiary center were included.Data on patient demographics, tumor characteristics, treatment, and outcomes were assessed and compared between groups.Results: No significant difference was noted between conventional hemicolectomy and complete mesocolic excision groups in terms of patient and tumor characteristics, chemotherapy, surgical morbidity, recurrence rates and apical node metastasis rates.The median total (58.0 vs 31.0,p<0.001) and apical lymph node yield (3.0 vs 2.0, p=0.034) were significantly higher with complete mesocolic excision than with conventional hemicolectomy, while there was a non-significant tendency toward a higher apical lymph node metastasis rate in the conventional hemicolectomy group (7.7% vs 2.1%).No significant difference was noted between the conventional hemicolectomy and complete mesocolic excision groups in terms of morbidity, length of hospital stay, recurrence, overall survival (66.7 vs 93.8% and 113.1 vs 74.9 months, respectively) and disease-free survival (64.1% vs 85.4% and 107.9 vs 68.7 months, respectively) at a median of 87.3 months and 25.1 months of follow-up, respectively.Conclusion: Complete mesocolic excision was not associated with an increased risk of surgical morbidity or mortality compared to conventional hemicolectomy.Our findings emphasise the likelihood of residual metastatic apical lymph nodes in nearly 5.6% of cases in which complete mesocolic excision is not used.There may also be a potential longer term survival benefit for complete mesocolic excision vs conventional hemicolectomy.