Application of developmental anatomy in laparoscopic complete mesocolic excision for right-sided colon cancer

Development of the midgut is characterized by rapid elongation of the gut and its mesentery, resulting in the formation of the primary intestinal loop, which rotates around an axis formed by the superior mesenteric artery. Eventually, a complex twisted intestinal and mesenteric anatomy is formed by displacement, rotation, and fusion. Therefore, we theoretically believed that the colon and its mesentery should be restored to the simple primitive mesenteric state, and then en bloc resection could be better performed. In the present study, we introduced a surgical technique for laparoscopic complete mesocolic excision (CME) based on the concept of developmental anatomy (DA group), which was successfully performed on 65 patients with right-sided colon cancer. As a control, traditional laparoscopic CME surgery (CME group) was also performed on 65 patients with right-sided colon cancer by the same surgical team at the same time period. Compare with the CME group, patients in the DA group presented with the less blood loss (20.3 ± 10.4 ml vs 34.6 ± 22.2 ml, p < 0.001), the shorter hospital day (6.4 ± 2.2 days vs 7.5 ± 2.2 days, p = 0.007), and the higher lymph node lymph node harvested (48.3 ± 12.7 vs 33.0 ± 11.2, p < 0.001), whereas the oncologic outcomes at 12 months follow-up did not differ significantly. In conclusion, the surgical procedure of CME based on the concept of developmental anatomy is technically safe and feasible for right-sided colon cancer.