Evidence map›Paper›PMID 24477788›Full record

ArticleInternational journal of colorectal disease2014

The rationale behind complete mesocolic excision (CME) and a central vascular ligation for colon cancer in open and laparoscopic surgery : proceedings of a consensus conference.

K Søndenaa, P Quirke, W Hohenberger, K Sugihara, H Kobayashi, H Kessler, G Brown, V Tudyka, A D'Hoore, R H Kennedy and 6 more

Abstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in International journal of colorectal disease, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
104citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

104 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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44 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

K SøndenaaDepartment of Surgery, Haraldsplass Deaconess Hospital, POB 6165, 5892, Bergen, Norway, kasoende@online.no.
P Quirke
W Hohenberger
K Sugihara
H Kobayashi
H Kessler
G Brown
V Tudyka
A D'Hoore
R H Kennedy
N P West
S H Kim
R Heald
K E Storli
A Nesbakken
B Moran

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt has been evident for a while that the result after resection for colon cancer may not have been optimal. Several years ago, this was showed by some leading surgeons in the USA but a concept of improving results was not consistently pursued. Later, surgeons in Europe and Japan have increasingly adopted the more radical principle of complete mesocolic excision (CME) as the optimal approach for colon cancer. The concept of CME is a similar philosophy to that of total mesorectal excision for rectal cancer and precise terminology and optimal surgery are key factors.

methodThere are three essential components to CME. The main component involves a dissection between the mesenteric plane and the parietal fascia and removal of the mesentery within a complete envelope of mesenteric fascia and visceral peritoneum that contains all lymph nodes draining the tumour area (Hohenberger et al., Colorectal Disease 11:354-365, 2009; West et al., J Clin Oncol 28:272-278, 2009). The second component is a central vascular tie to completely remove all lymph nodes in the central (vertical) direction. The third component is resection of an adequate length of bowel to remove involved pericolic lymph nodes in the longitudinal direction.

resultThe oncological rationale for CME and various technical aspects of the surgical management will be explored.

conclusionThe consensus conference agreed that there are sound oncological hypotheses for a more radical approach than has been common up to now. However, this may not necessarily apply in early stages of the tumour stage. Laparoscopic resection appears to be equally well suited for resection as open surgery.

Indexed as

ColectomyColonic NeoplasmsDissectionFasciotomyHumansLaparoscopyLigationLymphatic MetastasisLymph Node ExcisionMesocolonNeoplasm InvasivenessNeoplasm MicrometastasisNeoplasm StagingVascular Surgical Procedures

Identifiers

PMID24477788

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.