Surgical and pathological outcomes of complete mesocolic excision compared with conventional surgery in right colon cancers

Objective: To compare the surgical and pathological outcomes of complete mesocolic excision (CME) with conventional surgery in colon cancers. Methods: 125 patients with right colon cancer received surgical treatment were enrolled in the retrospective study, of whom, 59 underwent CME surgery (CME group) and 66 underwent conventional radical surgery (control group). Surgical specimens of the CME group were then prepared as pathological large format with the complete mesocolon. Hematoxylin-eosin staining and subsequent pathological analyses were conducted. Results: The number of dissected lymph node was larger in the CME group than that in the control group (29.7 ± 6.1 vs. 19.3 ± 5.3, P < 0.05). Similar results were observed in subgroups of stage I, II, and III colon cancers (25.2 ± 5.7 vs. 13.2 ± 5.6, 31.3 ± 7.7 vs. 19.6 ± 6.2, 30.3 ± 8.4 vs. 25.2 ± 7.2, respectively; P < 0.05). And also, larger mesocolon area, longer distance from vascular high ligation point to intestinal wall, and longer distance from vascular high ligation point to tumor center were observed in CME group (P < 0.05). The pathological large format could be used to identify mesenteric lymphatic metastasis (59.32%) and observe the dynamics of continuous and skip metastases of colon cancer along with the lymphatic vessels in a single slice. Conclusions: CME is appropriate in colon cancer surgery and it reveals the status of lymph node metastasis more precisely. The pathological large format is potential for illustrating the biological behavior of colon cancer. This technique is worth considering as a quality control standard for colon cancer surgery.