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International Journal of Colorectal Disease

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01-09-2021 | Colectomy | Original Article

Right-side colectomy with complete mesocolic excision vs conventional right-side colectomy in the treatment of colon cancer: a systematic review and meta-analysis

Authors: Valentina Ferri, Emilio Vicente, Yolanda Quijano, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malave, Ruben Agresott, Roberta Isernia, Pablo Cardinal-Fernandez, Pablo Ruiz, Valentina Nola, Giovanni de Nobili, Benedetto Ielpo, Riccardo Caruso

Published in: International Journal of Colorectal Disease | Issue 9/2021

Abstract

Background

This meta-analysis aims to investigate the role of complete mesocolic excision (CME) in the treatment of right-side colon cancer when compared with standard right-side hemicolectomy, focusing on oncological outcomes, mortality and morbidity rates.

Materials and methods

A systematic literature search was performed on MEDLINE and EMBASE archives, including studies on CME in right-side colon cancer. Primary outcomes were five-year disease-free survival and five-year overall survival. Secondary outcomes investigated were mortality and morbidity rates, intraoperative blood loss, anastomotic leakage, postoperative ileus, day of postoperative flatus, pulmonary infection, duration of hospital stay and number of lymph nodes harvested.

Results

Seventeen studies have been included in this meta-analysis for a total of 3918 patients. The five-year disease-free survival (DFS) and overall survival (OS) results improved in the CME group with respect to conventional right-side colectomy with an OR 1.88 (95% CI 1.02–3.45) and OR 2.77 (95% CI 1.33–5.74), respectively. The incidence of mortality and morbidity was comparable between the two groups. Moreover, conventional surgery time was faster than CME (MD 33.69 min, 95% CI 12.79–54.59), while no significant differences were reported in mean blood loss and hospital stay. Furthermore, the CME group showed a higher mean number of harvested lymph nodes (MD 7.08 lymph nodes 95% CI 4.90–9.27).

Conclusion

Complete mesocolic excision of the right-side colectomy improves oncological outcomes without increasing mortality and morbidity rates compared to standard right-side hemicolectomy. CME should therefore be routinely performed in the treatment of right-side colon cancer.

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Title: Right-side colectomy with complete mesocolic excision vs conventional right-side colectomy in the treatment of colon cancer: a systematic review and meta-analysis
Authors: Valentina Ferri
Emilio Vicente
Yolanda Quijano
Hipolito Duran
Eduardo Diaz
Isabel Fabra
Luis Malave
Ruben Agresott
Roberta Isernia
Pablo Cardinal-Fernandez
Pablo Ruiz
Valentina Nola
Giovanni de Nobili
Benedetto Ielpo
Riccardo Caruso
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Colectomy
Colectomy
Hemicolectomy
Hemicolectomy
Colon Cancer
Colon Cancer
Published in: International Journal of Colorectal Disease / Issue 9/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-021-03951-5

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Right-side colectomy with complete mesocolic excision vs conventional right-side colectomy in the treatment of colon cancer: a systematic review and meta-analysis

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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