Achieving complete mesocolic excision (CME) for colon cancer by laparoscopy

In accordance to the total mesorectal excision concept for rectal cancer, that of the complete mesocolic excision (CME) for colon cancer has been recently developed. CME involves dissection along the embryological planes, ligation and division of the supplying vessels at their origin and removal of a specimen with intact fascia and peritoneum, adequate distal and proximal bowel margin as well as the maximum number of the regional lymph nodes. CME surgery seems to achieve better oncological outcomes, in terms of local recurrence and survival, as compared to standard colectomy. CME has also been attempted by the laparoscopic approach. Provided that the tumour is located at the left or right and not at the transverse, a specimen of high quality can be resected, similar to that obtained by the open approach. There is also evidence that the oncological results of laparoscopic CME are superior to those achieved by the standard laparoscopic surgery, and similar to those achieved by open CME.