What is Mesocolic?

Mesocolic plane, defined as “good” plane, has intact mesocolon. Intramesocolic plane, defined as “moderate” plane, has irregular disruption in the mesocolon, but they do not reach down to the muscularis propria.

What is Mesocolic excision?

Abstract. Total mesorectal excision (TME) has been the miracle surgical technique which has since allowed the outcomes of rectal cancer to surpass that of colon cancer. Complete mesocolic excision (CME) attempts to adopt the same principles as that of TME and apply it to colon cancer surgery.

What is central vascular ligation?

Introduction. Complete mesocolic excision (CME) with central vascular ligation (CVL) in right colon cancer surgery is defined as mobilization of the colon with accurate surgical dissection of the mesocolic plane and division of named vessels at their origin from the superior mesenteric artery and vein (SMA/V) 1, 2.

What is trunk Henle?

The Henle trunk, defined as confluence of the right gastroepiploic vein (RGEV) with one or more colic veins, and with or without a pancreatic vein, was present in 89.7% of specimens (Table 2 and Fig. 3).

What is D3 dissection?

D3 lymph node dissection was defined as removal of main lymph nodes at the root of the feeding vessels (ileocolic vessels and the right branch of the middle colic artery or middle colic artery), followed by ligation of vessels at the origin site (Fig. 1).

What is D3 surgery?

All other than D2 ectomies are considered as non-standard procedures. D3 is defined as D2 +stations 13–16 (peripancreatic, superior mesenteric, meso-colic and para-aortic) (4). According to the latest TNM described in AJCC manual (8th edition), involvement of these stations are categorized as metastasis (M1) (5).

What is the mesenteric vein?

The superior mesenteric vein (SMV) is a large blood vessel in the abdomen. Its function is to drain blood from the small intestine as well as the first sections of the large intestine and other digestive organs. This large vein receives blood from several other veins (tributaries) in the digestive tract.

Where does IMV drain?

The inferior mesenteric vein usually drains into the splenic vein; however, anatomical variants where it drains to the superior mesenteric vein or at the splenoportal angle are not uncommon.

What is transverse mesocolon?

The transverse mesocolon is a broad, meso-fold of peritoneum, which connects the transverse colon to the posterior wall of the abdomen.

What is the difference between mesocolon and mesentery?

is that mesentery is (anatomy) the membrane that attaches the intestines to the wall of the abdomen, maintaining their position in the abdominal cavity, and supplying them with blood vessels, nerves, and lymphatics while mesocolon is (anatomy) the part of the mesentery that attaches the colon to the abdominal wall.

How many lymph nodes are removed during a right hemicolectomy?

Standard Is Removal of 12 Lymph Nodes But the number of lymph nodes that can be obtained in surgical resection specimens is influenced by numerous factors, including nonmodifiable factors related to the patient and tumor.

What is the pathophysiology of a mesocolic hernia?

Mesocolic hernias are unusual congenital hernias in which the small intestine herniates behind the mesocolon. They result from abnormal rotation of the midgut and have been categorized as right or left.

Where does the mesocolon attach to the pancreas?

The transverse mesocolon attaches centrally and obliquely from the anterior aspect of the descending part of the duodenum, over the head and neck of the pancreas superior to the duodenojejunal junction, and over the superior pole of the left kidney to the left colic flexure (seeFigs 62.2 – 62.4 ).

What is the mesocolon in diverticulitis?

The mesocolon or mesentery of the sigmoid colon provides a major avenue for spread of disease between the abdominal cavity and the pelvis. It is directly continuous with the posterior bare area of the colon, the bare area of the rectum, and in females, the broad ligament. Diverticulitis usually spreads into and is confined by the sigmoid mesocolon.

What is complete mesocolic excision (CME)?

We believe that complete removal of an intact mesocolonic envelope (complete mesocolic excision), along with central vascular ligation and apical node dissection, is essential for improving the outcomes. CONTROVERSIES REGARDING CME There is a great deal of discussion and debate regarding whether the CME concept is new.