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Lymph node recurrence after right colon resection for cancer: evidence for the utilisation of complete mesocolic excision
  1. Tara M Connelly,
  2. Cillian Clancy,
  3. Scott R Steele and
  4. Hermann Kessler
  1. Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA
  1. Correspondence to Tara M Connelly; connellyt2{at}ccf.org

Abstract

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.

  • Cancer intervention
  • Gastrointestinal system
  • Surgical oncology
  • Gastrointestinal surgery

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Footnotes

  • Contributors TC: planning, conduct, reporting, conception and design, acquisition of data. CC: planning, conduct, reporting, conception and design, acquisition of data. HK: planning, conduct, reporting, conception and design, acquisition of data, editing. SRS: planning, conduct, reporting, conception and design, editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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