Lymph node recurrence after right colon resection for cancer: evidence for the utilisation of complete mesocolic excision.


Journal

BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291

Informations de publication

Date de publication:
12 May 2022
Historique:
pmc-release: 12 05 2024
entrez: 13 5 2022
pubmed: 14 5 2022
medline: 20 5 2022
Statut: epublish

Résumé

Complete mesocolic excision (CME) of colon cancer is a resection performed along embryological planes to include the completely intact mesentery surrounding the tumour with a high central vascular ligation. The aim is to remove all lymph nodes draining the cancer. Proponents of the technique cite the significantly decreased local recurrence and improved 5-year survival rates associated with CME versus conventional colectomy. Although increasingly performed in many centres, it has not yet gained widespread acceptance as it is technically more challenging and can incur an increased bleeding risk. A man in his 80s underwent a conventional right hemicolectomy for a pT4aN2aM0 ascending colon cancer at another institution. This was followed by chemotherapy. He presented to our institution 2 years later with an isolated 3.7×3.2 cm mesenteric tumour adjacent to his anastomosis. There was no intraluminal recurrence. He then underwent a repeat extended right colectomy with CME. Pathology confirmed lymph node recurrence. His case demonstrates the importance of CME in reducing carcinoma recurrence risk.

Identifiants

pubmed: 35550325
pii: 15/5/e247904
doi: 10.1136/bcr-2021-247904
pmc: PMC9109023
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Tara M Connelly (TM)

Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA connellyt2@ccf.org.

Cillian Clancy (C)

Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.

Scott R Steele (SR)

Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.

Hermann Kessler (H)

Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.

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