CC BY 4.0 · Journal of Coloproctology 2024; 44(S 01): S1-S138
DOI: 10.1055/s-0045-1808853
Câncer do Cólon/Reto/Ânus
Colon/Rectum/Anus Cancer
ID – 141617
Open Topics (oral presentation)

COMPLETE MESOCOLIC EXCISION VERSUS CONVENTIONAL D2 LYMPHADENECTOMY IN RIGHT HEMICOLECTOMY: A META-ANALYSIS OF PROPENSITY SCORE MATCHED STUDIES AND RANDOMIZED CONTROLLED TRIALS

Bernardo Fontel Pompeu
1   Hospital Heliópolis, São Paulo Brasil
,
Eric Pasqualotto
2   Universidade Federal de Santa Catarina, Florianópolis, Brasil
,
Patrícia Marcolin
3   Universidade Federal Fronteira do Sul Passo Fundo, Passo Fundo, Brasil
,
Lucas Monteiro Delgado
4   Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
,
Beatriz D'andrea Pigossi
1   Hospital Heliópolis, São Paulo Brasil
,
Sergio Mazzola Poli de Figueiredo
,
Fernanda Bellotti Formiga
1   Hospital Heliópolis, São Paulo Brasil
› Author Affiliations
 

    Introduction The complete mesocolic excision (CME) in right-sided hemicolectomy could result in higher lymph node yield and decreased local recurrence. However, this approach could increase intraoperative and postoperative complications.

    Objective Our meta-analysis aims to demonstrate the outcomes of CME versus D2 conventional lymphadenectomy for right-sided colon cancer.

    Methods We searched MEDLINE, Cochrane, Central Register of Clinical Trials, and EMBASE for studies published until April 2024. Odds ratios (OR) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using the Cochran Q test and I² statistics, with p-values < 0.10 and I²> 25% considered significant. Statistical analysis was performed using R Software, version 4.1.2.

    Results Three randomized controlled trials and four observational studies comprising 2,296 patients were included, of whom 1,138 (49.6%) were submitted to the CME and 1,158 (50.4%) to the conventional D2 lymphadenectomy. CME was associated with decreased local recurrence rates (OR 0.07; 95% CI 0.01 to 0.36; p=0.002). There were no significant differences between groups in overall complications, severe complications, intraoperative complications, blood loss, and 30-day mortality. No difference between groups was observed in distance metastasis and 3-year disease-free survival.

    Conclusion In this meta-analysis, CME significantly decreased local recurrence rates and increased the number of harvested lymph nodes compared with D2 lymphadenectomy in patients with right-side colon cancer. No difference was observed between groups in rates of overall complications, severe complications, intraoperative complications, blood loss, and 30-day mortality.


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    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    25 April 2025

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