LAUSR

Complete mesocolic excision (CME) lacks consistent data to advocate operative superiority compared to conventional surgery for colon cancer. We performed a systematic review and meta-analyses, analysing peri-operative, pathological, and oncological outcomes. A systematic literature review was registered with PROSPERO and carried out using PRISMA guidelines. Outcomes reviewed included lymph node yield, R0, disease free and overall survival at five years. 3039 citations were identified; 148 studies underwent full-text reviews and 34 matched our inclusion criteria. There were no significant differences between the CME and non-CME group in overall complications (13.8% vs.13.8%) or anastomotic leak (1.3% vs. 1.7%). Nodal yield was higher in the CME group, 18.7 compared to 13.6 in the non-CME group. The rate of R0 resection was 96.8% in CME compared to 95.5%. Overall survival at five years was higher in the CME group 77.8% compared to 69.7% in non-CME group. CME for colon cancer was associated with no significant differences in morbidity and mortality, better lymph node yield and R0 resection compared to the non-CME group. Our meta-analysis further supported this demonstrating an improved overall and disease-free survival at five years in the CME group compared to the non-CME group.