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Complete Mesocolic Excision (CME)

Mesocolic plane dissection with central vascular ligation in colon cancer.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Complete Mesocolic Excision (CME)?

Complete mesocolic excision (CME) preserves the mesocolic fascia, removes the entire mesocolon by sharp dissection, and ligates the feeding vessels at their central origin in colon cancer surgery.

Described by Hohenberger, the technique adapts the principles of TME from the rectum to the colon. Central vascular ligation is combined with D3 lymph node dissection at the mesenteric root.

CME has improved 5-year cancer-specific survival in colon cancer from approximately 58 to 89 percent, with local recurrence falling from about 6 to 3 percent. The technique is feasible by laparoscopic and robotic platforms but requires expertise.

Symptoms

Histologically confirmed colon adenocarcinoma
T2 to T4 stage colon cancer
Lymph node-positive disease
Right, transverse, and left colon tumors
Resectable disease
Patients without synchronous metastases
Good performance status
Candidates for D3 lymphadenectomy

Risk Factors

Superior mesenteric vein injury
Duodenal and pancreatic injury
Massive hemorrhage during central dissection
Prolonged operative time
Anastomotic leak
Obesity and adhesions
Risk of conversion to open surgery
Steep learning curve

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Signs of anastomotic leak
  • Bleeding and hemodynamic changes
  • Prolonged ileus
  • Findings of intra-abdominal infection
  • Wound complications
  • Delayed return of bowel function

Treatment Methods

01
Preoperative CT and angiographic assessment
02
Laparoscopic, robotic, or open approach
03
Sharp dissection in the mesocolic fascial plane
04
Central vascular ligation of superior or inferior mesenteric artery branches
05
D3 lymphadenectomy with apical lymph nodes
06
Preservation of mesocolic envelope integrity
07
Intracorporeal or extracorporeal anastomosis
08
Pathological scoring of mesocolic specimen quality

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.