title: Laparoscopic Complete Mesocolic Excision for Stage II/III Left-Sided Colon Cancers: A Prospective Study and Comparison with D3 Lymph Node Dissection.
abstract: BACKGROUND
  To investigate the similarities and differences of laparoscopic complete mesocolic excision (CME) to a colon resection with a D3 lymphadenectomy for the stage II/III left-sided colon carcinoma.
  
  
  METHODS
  Patients between July 2011 and August 2014 were randomized into D3 and CME groups. Mesenteric area, log odds of positive lymph nodes (LODDS), and other operative parameters were collected and assessed.
  
  
  RESULTS
  The average specimen sizes were 5730 ± 828 mm(2) in superior rectal artery (SRA)-preserving D3, 8145 ± 1022 mm(2) in SRA-nonpreserving D3, and 8745 ± 1039 mm(2) in the CME group; the differences were significant (P < .0001). The number of lymph nodes collected from CME specimens was larger, but the CME specimens did not contain an elevated value of LODDS or positive nodes or lymph node ratio (LNR). There were also no significant differences between recovery times of bowel function. Although it took more operation time in D3 approach, especially in SRA-preserving D3 operation, the difference was not significant. Concerning the leakage rate (P = .34) and vessel-related complications (P = .64), there were no significant differences either.
  
  
  CONCLUSIONS
  Both standard D3 resection and CME could achieve a high quality of mesocolic plane grade for stage II/III colon cancer. The LODDS and LNR were comparable, and those were not relevant to mesenteric size.
authors.affiliation: 1 Department of General, Visceral, Transplantation, and Vascular Thoracic Surgery, Hospital of University of LMU Munich , Munich, Germany .|2 Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Hao
authors.initials: H
authors.lastname: Feng
authors.affiliation: 3 PLA 309 Hospital , Beijing, China .
authors.forename: Xue-Wei
authors.initials: XW
authors.lastname: Zhao
authors.affiliation: 2 Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: 2 Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Ding-Pei
authors.initials: DP
authors.lastname: Han
authors.affiliation: 2 Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Zhi-Hai
authors.initials: ZH
authors.lastname: Mao
authors.affiliation: 2 Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .
authors.forename: Ai-Guo
authors.initials: AG
authors.lastname: Lu
authors.affiliation: 4 Department of General and Visceral Surgery, Munich Red Cross Hospital , Munich, Germany .
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Thasler
mesh_terms: D000368:Aged; D003082:Colectomy / Q000009:adverse effects; D003106:Colon / Q000503:physiopathology; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000601:surgery; D008646:Mesocolon / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011446:Prospective Studies; D020127:Recovery of Function; D012007:Rectum / Q000503:physiopathology; D047368:Tumor Burden