CME in right-sided colon cancer: the new gold standard?
Seance of wednesday 05 march 2025 (Journée cancérologie : Cancer colorectal)
DOI number : 10.26299/d65d-a182/2025.09.07
Abstract
Inspired by the total mesorectal excision (TME) technique used to reduce recurrences of rectal cancer, Hohenberger introduced in 2009 the concept of complete mesocolic excision (CME) for the resection of colon cancer, particularly on the right side.
This approach involves performing an oncologic right colectomy with extensive lymphadenectomy by ligating the ileocolic vessels, the right colic vessels, and the right branch of the middle colic vessels at their origin, after visualizing and dissecting the anterior surface of the superior mesenteric vein while respecting embryological planes. This technique may increase the risk of intraoperative vascular injury. Therefore, it requires proper training and standardization.
At present, it cannot be considered the gold standard for the surgical management of right-sided colon cancer, as although it improves lymphadenectomy, its impact on survival has yet to be demonstrated, with the current level of evidence remaining insufficient.
This approach involves performing an oncologic right colectomy with extensive lymphadenectomy by ligating the ileocolic vessels, the right colic vessels, and the right branch of the middle colic vessels at their origin, after visualizing and dissecting the anterior surface of the superior mesenteric vein while respecting embryological planes. This technique may increase the risk of intraoperative vascular injury. Therefore, it requires proper training and standardization.
At present, it cannot be considered the gold standard for the surgical management of right-sided colon cancer, as although it improves lymphadenectomy, its impact on survival has yet to be demonstrated, with the current level of evidence remaining insufficient.