Excisão Completa do Mesocólon - Revisão da literatura

  • Carla Carneiro Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
  • Ricardo Rocha Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
  • Rui Marinho Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
  • António Gomes Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
  • Carlos Leichsenring Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
  • Vasco Geraldes Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
  • Vitor Nunes Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.

Abstract

Desde a descrição da Excisão Total do Mesorreto (TME), a taxa de recidiva local da neoplasia do recto desceu de 20 a 40% para cerca de 10%(1,2). É neste contexto, que Hohenberger descreve em 2008 a Excisão Completa do Mesocólon (Complete Mesocolic Excision, CME)(3). Trata-se de uma técnica cirúrgica mais radical, tendo como base teórica e conceptual os mesmos princípios descritos por Heald para a TME. Com a CME estão descritas taxa de recidiva locorregional de 3,6% e sobrevida global aos 5 anos de 89%, resultados substancialmente melhores que os relatados na literatura utilizando a técnica convencional. Foi efetuada uma revisão da literatura com o termo “Complete Mesocolic Excision”, utilizando a base de dados pubMed, sem restrição temporal. Analisamos 52 artigos, quanto a questões referentes à técnica e anatomia cirúrgica, complicações da técnica, avaliação morfológica do espécime cirúrgico; resultados oncológicos medidos como recidiva e sobrevida global, reprodutibilidade da cirurgia e seus resultados noutros centros e na abordagem laparoscópica. A CME é uma técnica promissora, estandardizada, com resultados oncológicos superiores, sem maior taxa de complicações cirúrgicas.

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Author Biographies

Carla Carneiro, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
Assistente Cirurgia Geral
Ricardo Rocha, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
Interno de Formação Específica Cirurgia Geral
Rui Marinho, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.

Interno de Formação Específica Cirurgia Geral

António Gomes, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
Assistente Cirurgia Geral
Carlos Leichsenring, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
Assistente Cirurgia Geral
Vasco Geraldes, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.
Assistente Graduado Cirurgia Geral
Vitor Nunes, Serviço de Cirurgia B - Hospital Prof.Dr. Fernando Fonseca E.P.E.

Assistente Graduado Sénior Cirurgia Geral

Director de Serviço

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Published
2016-09-30
How to Cite
CARNEIRO, Carla et al. Excisão Completa do Mesocólon - Revisão da literatura. Revista Portuguesa de Cirurgia, [S.l.], n. 38, p. 19 - 29, sep. 2016. ISSN 2183-1165. Available at: <https://revista.spcir.com/index.php/spcir/article/view/479>. Date accessed: 26 apr. 2024.
Section
Review Article