Complete Mesocolic Excision for the Treatment of Right-Sided Colon Cancer: Anatomical Consideration, Surgical Technique and Outcomes

Since total mesorectal excision (TME) reduces local recurrence rates, it is considered the gold standard surgical procedure for treating locally advanced rectal cancer. These discoveries led to the use of the dissection principle in colon cancer surgery using complete mesocolic excision (CME) and central vascular ligation (CVL). A successful CME operation encompasses three critical components: the specimen must be removed in the mesocolic plane, the supplying blood vessels should be ligated at their origin, and an adequate length of the colon must be removed. Education and comprehensive knowledge of vessel anatomy are essential; otherwise, there is a risk of increased morbidity. CME implementation began with the aim of developing a new concept for colon cancer surgery that would improve patient outcomes. This operation yields high-quality specimens that may suggest better long-term oncologic outcomes, although the morbidity associated with CME is typically higher than that of standard right hemicolectomy. To date, published series on CME are predominantly retrospective and heterogeneous. As a consequence, the analysis of oncological findings should be approached with caution. Evidence regarding the quality is insufficient and does not consistently demonstrate the superiority of CME.