ArticleSurgical endoscopy2019
The fusion fascia of Fredet: an important embryological landmark for complete mesocolic excision and D3-lymphadenectomy in right colon cancer.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Minimally invasive complete mesocolic excision versus conventional right hemicolectomy for right-sided colon cancer: a systematic review and meta-analysis.BMC surgery · 2025Pooled it
- Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review.Surgical endoscopy · 2023Pooled it
- Right hemicolectomy with complete mesocolic excision is safe, leads to an increased lymph node yield and to increased survival: results of a systematic review and meta-analysis.Techniques in coloproctology · 2021Pooled it
- Complete mesocolic excision and D3 lymphadenectomy with central vascular ligation in right-sided colon cancer: a systematic review of postoperative outcomes, tumor recurrence and overall survival.Surgical endoscopy · 2021Pooled it
- Review
- Efficacy of the "critical view/open book" concept for implementing standardized right hemicolectomy with complete mesocolic excision-results from a series of minimally invasive surgical training courses.Surgical endoscopy · 2026Article
- Article
- The Role of the Mesopancreas in Pancreatic Neuroendocrine Neoplasms.Journal of clinical medicine · 2026Article
- Increased Risk of Central Mesocolic Lymph Node Metastases in BRAF-Mutated Stage I-III Colon Cancer.Journal of clinical medicine · 2026Article
- Thin-Adipose Compartment at the Colonic Mesentery-Perirenal Fat Interface: Histological and Three-Dimensional Morphological Studies.International journal of urology : official journal of the Japanese Urological Association · 2026Article
- The right hemicolon fascial system: a narrative review.Frontiers in surgery · 2026Review
- Review
- Complete Mesocolic Excision for Colon Cancer: Insight into Potential Mechanisms of Oncologic Benefit.Cancers · 2025Review
- Fused Ischiorectal Phlegmon with Pre- and Retroperitoneal Extension: Case Report and Narrative Literature Review.Journal of clinical medicine · 2025Review
- Article
- Factor analysis of postsurgical gastroparesis syndrome after right hemicolectomy for colon cancer.Oncology letters · 2025Article
- Most oncological pancreas resections must consider the mesopancreas.BMC cancer · 2025Article
- Retrocolic Fascia-An Anatomical and Multidetector Computed Tomographic Angiography (MDCTA) Morphometric Analysis in Patients with Right Colon Cancer.Diagnostics (Basel, Switzerland) · 2024Article
- Proposal for standardization of laparoscopic D3 lymphadenectomy for right colon cancer.Techniques in coloproctology · 2024Observational
- Retroperitoneum revisited: a review of radiological literature and updated concept of retroperitoneal fascial anatomy with imaging features and correlating anatomy.Surgical and radiologic anatomy : SRA · 2024Review
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe fusion fascia of Toldt is a well-known landmark used by colorectal surgeons. On the contrary, the fusion fascia of Fredet (the plane between the ascending mesocolon and the visceral duodenal-pancreatic peritoneum) still remains a neglected embryological structure. Aim of this study was to provide an anatomic description of this fascia and its application to minimally invasive D3-lymphadenectomy (D3-L) and complete mesocolic excision (CME) for right colon cancer.
methodsFirst phase: Cadaveric dissection and anatomic description of the fascia of Fredet. Second phase: prospective evaluation of its surgical application in a consecutive series of laparoscopic right hemicolectomies with CME and D3-L at a tertiary hospital.
resultsThe fascia of Fredet was identified and dissected in one fresh and two formalin-fixed cadavers. The trunk of Henle and the medial border of the superior mesenteric vein defined the medial limit of this embryologic plane. Seventeen patients were operated on. Laparoscopic dissection of the fascia of Fredet was possible in every patient. Median operative time was 210 (120-380) min. There were no major postoperative complications. All cases were adenocarcinomas, except one adenomatous polyp. T stage was Tis in three, T2 in two, T3 in seven, and T4 in five patients. Median number of harvested lymph nodes was 24 (9-39). Lymphatic invasion was found in six patients. All resections were classified as satisfactory mesocolic excision and R0. Median postoperative length of stay was 6 (4-20) days. Median follow-up time was 28 (16-41) months. Local and distal recurrence rate was 0.
conclusionThe fusion fascia of Fredet is useful to achieve CME and D3-L in right colon cancers with reduced risk of intraoperative complications. This structure is particularly suitable for minimally invasive surgery; therefore, we encourage awareness of the fascia of Fredet by colorectal surgeons.
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