Excisão Completa do Mesocólon - Revisão da literatura
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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