Concept of 3D lymph node dissection and complete mesocolic excision in surgical treatment of colon cancer



Embryology-oriented surgery is gaining popularity among surgeons nowadays. Such approach is introduced almost for all GI cancers. Complete mesocolic excision (CME) is a relatively new term in modern western European literature, appearing as translation of well known total mesorectal excision concept to colon. Opposed to the latter, CME concept is not recognized as widely as TME. This is mostly due to the lack of evidence to support any benefits of more complicated procedure, associated with higher morbidity rate. D3 concept, being introduced long ago, also failed to demonstrate unequivocal superiority compared to standard dissection level. Current trend towards standardization of surgical treatment require development of unified indications for extended dissections as well as the surgical technique itself.