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This session will cover a Complete Mesocolic Excision (CME) with D3 dissection for colon cancer. This is a modern type of combined surgical procedure. Currently, both European and Japanese doctors are doing an increasing number of these procedures with lymph node dissection and Complete Mesocolic Excision.


First, he goes over statistics regarding how many cases are performed each year in Japan, then moves on to provide a brief overview of the history of D3 dissection surgery in Japan.   


Dr. Tsuyoshi Konisihi affirms that many studies with oncologic outcomes for colon cancer have not improved as much as the outcomes for rectal cancer.


When it comes to the learning curve of CME procedures in rectal cancer, we should point out that many surgeons are performing this type of surgery as ‘minimally invasive surgery’ and there’s good transmission of knowledge on this topic. Nevertheless, while there’s no exact information about the learning curve, it is the doctor’s opinion that a laparoscopic procedure needs at least 10 cases to feel comfortable. 


Bearing in mind that we are coping with a treatable metastasis, it is necessary to perform CME with D3 dissection in metastatic cancer. Also, the doctor tells us that this kind of surgery was treated as being very specific in the past but over the years these operations have become more common.


In conclusion, the prevention of colorectal cancers is very important for the maintenance of a healthy population. 

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Dr. Tsuyoshi Konishi MD, PhD, Associate Professor, Department of Colon and Rectal Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA Colorectal Surgery
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