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. 2023 Feb;37(2):846-861.
doi: 10.1007/s00464-022-09548-5. Epub 2022 Sep 12.

Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review

Giuseppe S Sica  1   2 , Danilo Vinci  3 , Leandro Siragusa  4   3 , Bruno Sensi  4   3 , Andrea M Guida  3 , Vittoria Bellato  3   5 , Álvaro García-Granero  6   7   8 , Gianluca Pellino  9   10
Affiliations

Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review

Giuseppe S Sica et al. Surg Endosc. 2023 Feb.

Erratum in

Abstract

Background: Several procedures have been proposed to reduce the rates of recurrence in patients with right-sided colon cancer. Different procedures for a radical right colectomy (RRC), including extended D3 lymphadenectomy, complete mesocolic excision and central vascular ligation have been associated with survival benefits by some authors, but results are inconsistent. The aim of this study was to assess the variability in definition and reporting of RRC, which might be responsible for significant differences in outcome evaluation.

Methods: PRISMA-compliant systematic literature review to identify the definitions of RRC. Primary aims were to identify surgical steps and different nomenclature for RRC. Secondary aims were description of heterogeneity and overlap among different RRC techniques.

Results: Ninety-nine articles satisfied inclusion criteria. Eight surgical steps were identified and recorded as specific to RRC: Central arterial ligation was described in 100% of the included studies; preservation of mesocolic integrity in 73% and dissection along the SMV plane in 67%. Other surgical steps were inconstantly reported. Six differently named techniques for RRC have been identified. There were 35 definitions for the 6 techniques and 40% of these were used to identify more than one technique.

Conclusions: The only universally adopted surgical step for RRC is central arterial ligation. There is great heterogeneity and consistent overlap among definitions of all RRC techniques. This is likely to jeopardise the interpretation of the outcomes of studies on the topic. Consistent use of definitions and reporting of procedures are needed to obtain reliable conclusions in future trials. PROSPERO CRD42021241650.

Keywords: Colorectal cancer; Colorectal surgery; Complete mesocolic excision; D3 lymphadenectomy; Right colectomy.

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Conflict of interest statement

Giuseppe S. Sica, Danilo Vinci, Leandro Siragusa, Bruno Sensi, Andrea Guida, Vittoria Bellato, Alvaro Garcia-Granero and Gianluca Pellino have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow-chart for the systematic search process
See this image and copyright information in PMC

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