• Giuseppe Di Buono, Salvatore Buscemi, Gianfranco Cocorullo, Vincenzo Sorce, Giuseppe Amato, Giulia Bonventre, Elisa Maienza, Massimo Galia, Leonardo Gulotta, Giorgio Romano, and Antonino Agrusa.
• Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
• Ann. Surg. 2021 Jul 1; 274 (1): 57-62.

ObjectiveThe aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group).Summary Background DataAlthough CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use.MethodsIn this randomized controlled trial, several primary endpoints (operative time, intraoperative blood loss, other complications, conversion rate, and anastomotic leak) and secondary endpoints (overall postoperative complications) were evaluated. In addition, we evaluated histopathologic data, including specimen length and the number of lymph nodes harvested, as objective signs of the quality of CME, related to oncological outcomes.ResultsThe CME group had a significantly longer mean operative time than the NCME group (216.3 minutes vs 191.5 minutes, P = 0.005). However, the CME group had a higher number of lymph nodes (23.8 vs 16.6; P < 0.001) and larger surgical specimens (34.3 cm vs 29.3 cm; P = 0.002). No differences were reported with respect to intraoperative blood loss, conversion rate, leakage, or other postoperative complications.ConclusionsIn this study laparoscopic CME were a safe and feasible technique with improvement in lymph nodes harvesting and length of surgical specimens with no increase of surgical intraoperative and postoperative complications.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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