Surgical treatment of right colon cancer

Q4 Medicine
A. Nevolskikh, V. A. Avdeenko, I. P. Reznik, T. P. Pochuev, R. F. Zibirov, S. Ivanov, A. Kaprin
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Abstract

The study aimed to perform a systematic review of the literature on surgical treatment for right colon cancer (RCC) with complete mesocolic excision (CME) and D2/D3 lymph node dissection (LND). Material and Methods. A literature review was performed for studies published between 2013 and 2023 by the online resources from the official Web sites of the societies/panels and PubMed database. Sources included guidelines, meta-analyses, randomized and nonrandomized clinical studies, guidelines by European Society of Medical Oncology, the Japanese Society for Cancer of the Colon and Rectum, and the National Comprehensive Cancer Network, Russian clinical guidelines. Results. CME significantly improved both immediate and long-term treatment results, which was confirmed by numerous meta-analyses. The extent of LND remains one of the most controversial issues in RCC. For many Asian surgeons, D3 LND is the standard procedure for the treatment of RCC, whereas the European approach is more conservative and apical lymph node dissection is not mandatory. There are also large differences in understanding the extent of D3 LND in RCC. Most surgeons understand this term as dissection of adipose tissue along the anterior and lateral surface of the superior mesenteric vein, however, there are authors who perform circular dissection along the superior mesenteric vessels, considering this extent of surgery to be the most radical. Conclusion. It is necessary to standardize methods and effective criteria for quality control of CME for RCC and LND. In this case, external independent assessment of the quality of surgical intervention is important. There is also currently a growing number of studies in which intraoperative fluorescence imaging makes it possible to better visualize the location of the apical lymph nodes and individualize LND.
右结肠癌的手术治疗
本研究旨在对右侧结肠癌(RCC)完全系膜切除术(CME)和 D2/D3 淋巴结清扫术(LND)的手术治疗文献进行系统性回顾。材料与方法。通过学会/专家小组官方网站和 PubMed 数据库的在线资源,对 2013 年至 2023 年间发表的研究进行了文献综述。文献来源包括指南、荟萃分析、随机和非随机临床研究、欧洲肿瘤内科学会指南、日本结肠直肠癌学会指南、美国国家综合癌症网络指南、俄罗斯临床指南。研究结果CME能明显改善近期和远期治疗效果,这一点已被多项荟萃分析所证实。LND 的范围仍然是 RCC 中最具争议的问题之一。对于许多亚洲外科医生来说,D3 LND是治疗RCC的标准程序,而欧洲的方法则更为保守,不强制要求进行顶端淋巴结清扫。对于 RCC 的 D3 LND 范围的理解也存在很大差异。大多数外科医生将其理解为沿着肠系膜上静脉的前侧和外侧表面解剖脂肪组织,但也有学者沿着肠系膜上血管进行环形解剖,认为这种手术范围是最彻底的。结论。有必要为 RCC 和 LND 的 CME 质量控制制定标准化方法和有效标准。在这种情况下,对手术干预质量进行外部独立评估非常重要。目前也有越来越多的研究表明,术中荧光成像可以更好地观察顶端淋巴结的位置,并对LND进行个体化处理。
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来源期刊
Siberian journal of oncology
Siberian journal of oncology Medicine-Oncology
CiteScore
0.40
自引率
0.00%
发文量
117
审稿时长
8 weeks
期刊介绍: The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets
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