A Meta-analysis Of Complete Mesocolic Excision Versus Traditional Resection For Colon Cancer

Objective Research complete mesocolic excision(CME) compared to the traditional colon resection security and superiority.Methods We searched the literature on CME with traditional colon resection comparative study of the past five years, CNKI, Wanfang Database, VIP, CBM, Pub Med, Medline, OVID,Elsevier, Cochrane, etc., follow strict screening standard, to extract high quality literature data, using Review Manager 5.3 software to evaluate and analyse the final results.Results A total of 10 non-randomized clinical trials, including five English literature and five Chinese literature. Total cases 1,447 cases, including 733 cases of CME Group,traditional surgery group 714 cases. Meta-analysis results showed that:(1) CME Group was less blood loss than traditional surgery group [WMD =-28.17,95% CI(-52.77,-3.57), P = 0.02], the operative time difference was not statistically significant [WMD =3.70,95% CI(-18.25,25.66), P = 0.74];(2) As to the number of lymph node detected from postoperative pathological specimens,the average length of large bowel resected,the area of mesentery resected,and the high vascular ligation,CME group were superior to the traditional colon surgery group(P <O.01, P <O.01, P <0.01 and P<0.05);(3) There were no significant differences in the time of first flatus and the hospital stay between two groups(P = 0.45, P = 0.08);(4) The implementation of CME did not increase the incidence of major complications(P = 0.89).Conclusion Compared with traditional colon resection, CME is more safe, effective and feasible in conformity with the concept of surgery, anatomy and embryology. Without increasing the risk of surgery and postoperative complications, CME has achieved themaximization of the radical effects. CME is expected to become a standardized operation method for colon cancer.