title: Complete mesocolic excision in colon cancer surgery: a comparison between open and laparoscopic approach.
abstract: BACKGROUND
  Complete mesocolic excision (CME) with central vessel ligation (CVL) as performed in Erlangen offers the best long-term outcome for colon cancer. The aim of this study was to assess specimens after laparoscopic vs open CME-CVL macroscopically and morphometrically in patients with left and right colon cancers.
  
  
  METHODS
  All specimens were freshly photographed. Precise tumour morphometry and grading of the surgical plane were performed as described by pathologists in Leeds, UK.
  
  
  RESULTS
  Thirty-four specimens from right-sided cancers were divided into 18 transverse colon cancers (nine laparoscopic vs nine open) and 16 caecum-ascending colon cancers (seven laparoscopic vs nine open) and 56 specimens from left-sided cancers (33 laparoscopic vs 23 open). There was no difference between laparoscopically and open acquired left- and right-sided specimens. Specimens of transverse colon displayed differences in length of central ligation to tumour (open 11.67 cm vs laparoscopic 8.72 cm, P = 0.049), length of central ligation to bowel wall (open 9.11 cm vs laparoscopic 6.5 cm, P = 0.015) and lymph node clearance (open 46.33 vs laparoscopic 39.33, P = 0.033).
  
  
  CONCLUSIONS
  Laparoscopy seems to offer specimens of similar quality after CME-CVL surgery for colon cancer to the open approach. Issues of completeness of excision from laparoscopy are raised for tumours located in the transverse colon.
authors.affiliation: Agia Olga Hospital of Athens Athens Naval and Veterans Hospital, Athens Creta Interclinic Hospital, Heraklion, Greece. nikos.gouvas@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Gouvas
authors.forename: G
authors.initials: G
authors.lastname: Pechlivanides
authors.forename: N
authors.initials: N
authors.lastname: Zervakis
authors.forename: M
authors.initials: M
authors.lastname: Kafousi
authors.forename: E
authors.initials: E
authors.lastname: Xynos
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation; D008297:Male; D008646:Mesocolon / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010781:Photography; D011446:Prospective Studies; D013048:Specimen Handling