title: Short-term outcomes after complete mesocolic excision compared with 'conventional' colonic cancer surgery.
abstract: BACKGROUND
  Complete mesocolic excision (CME) seems to be associated with improved oncological outcomes compared with 'conventional' surgery, but there is a potential for higher morbidity.
  
  
  METHODS
  Data for patients after elective resection at the four centres in the Capital Region of Denmark (June 2008 to December 2013) were retrieved from the Danish Colorectal Cancer Group database and medical charts. Approval from a Danish ethics committee was not required (retrospective study).
  
  
  RESULTS
  Some 529 patients who underwent CME surgery at one centre were compared with 1701 patients undergoing 'conventional' resection at the other three hospitals. Laparoscopic CME was performed in 258 (48·8 per cent) and laparoscopic 'conventional' resection in 1172 (68·9 per cent). More extended right colectomy procedures were done in the CME group (17·4 versus 3·6 per cent). The 90-day mortality rate in the CME group was 6·2 per cent versus 4·9 per cent in the 'conventional' group (P = 0·219), with a propensity score-adjusted logistic regression odds ratio (OR) of 1·22 (95 per cent c.i. 0·79 to 1·87). Laparoscopic surgery was associated with a lower risk of mortality at 90 days (OR 0·63, 0·42 to 0·95). Intraoperative injury to other organs was more common in CME operations (9·1 per cent versus 3·6 per cent for 'conventional' resection; P < 0·001), including more splenic (3·2 versus 1·2 per cent; P = 0·004) and superior mesenteric vein (1·7 versus 0·2 per cent; P < 0·001) injuries. Rates of sepsis with vasopressor requirement (6·6 versus 3·2 per cent; P = 0·001) and postoperative respiratory failure (8·1 versus 3·4 per cent; P < 0·001) were higher in the CME group.
  
  
  CONCLUSIONS
  CME is associated with more intraoperative organ injuries and severe non-surgical complications than 'conventional' resection for colonic cancer.
authors.affiliation: Department of Surgery, Hillerød University Hospital, University of Copenhagen, Hillerød, Denmark.
authors.forename: C A
authors.initials: CA
authors.lastname: Bertelsen
authors.affiliation: Department of Surgery, Hillerød University Hospital, University of Copenhagen, Hillerød, Denmark.
authors.forename: A U
authors.initials: AU
authors.lastname: Neuenschwander
authors.affiliation: Department of Surgery, Hillerød University Hospital, University of Copenhagen, Hillerød, Denmark.
authors.forename: J E
authors.initials: JE
authors.lastname: Jansen
authors.affiliation: Department of Surgery, Herlev University Hospital, University of Copenhagen, Herlev, Denmark.|Department of Surgery, Køge Roskilde University Hospital, University of Copenhagen, Køge, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Kirkegaard-Klitbo
authors.affiliation: Department of Surgery, Bispebjerg University Hospital, University of Copenhagen, København, Denmark.
authors.forename: J R
authors.initials: JR
authors.lastname: Tenma
authors.affiliation: Department of Surgery, Hvidovre University Hospital, University of Copenhagen, Hvidovre, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Wilhelmsen
authors.affiliation: Department of Surgery, Hillerød University Hospital, University of Copenhagen, Hillerød, Denmark.
authors.forename: L A
authors.initials: LA
authors.lastname: Rasmussen
authors.affiliation: Department of Surgery, Hillerød University Hospital, University of Copenhagen, Hillerød, Denmark.
authors.forename: L V
authors.initials: LV
authors.lastname: Jepsen
authors.affiliation: Department of Clinical Physiology, Herlev University Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Kristensen
authors.affiliation: Department of Surgery, Køge Roskilde University Hospital, University of Copenhagen, Køge, Denmark.
authors.forename: I
authors.initials: I
authors.lastname: Gögenur
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D008646:Mesocolon / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D057216:Propensity Score; D012189:Retrospective Studies; D016896:Treatment Outcome