{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:36:20Z","timestamp":1788921380249,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,18]],"date-time":"2019-08-18T00:00:00Z","timestamp":1566086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,1]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n \n Complete mesocolic excision (\n CME<\/jats:styled-content>\n ) with central vascular ligation (\n CVL<\/jats:styled-content>\n ) has been advocated for right colon adenocarcinoma (\n RC<\/jats:styled-content>\n ), but the radicality of vascular dissection remains controversial. Our aim is to report outcomes of selective\n CVL<\/jats:styled-content>\n (D3 lymphadenectomy) during minimally invasive\n CME<\/jats:styled-content>\n for\n RC<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n A prospective database identified patients who were treated for\n RC<\/jats:styled-content>\n between 2009 and 2016. Minimally invasive\n CME<\/jats:styled-content>\n was standard. The radicality of lymphadenectomy was defined as high ligation (\n HL<\/jats:styled-content>\n ) versus\n CVL<\/jats:styled-content>\n based on operative reports and videos. Two blinded radiologists independently evaluated the pre\u2010 and postoperative\n CT<\/jats:styled-content>\n scans for radiographically abnormal nodes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 197 patients who underwent\n CME<\/jats:styled-content>\n ,\n HL<\/jats:styled-content>\n was performed in 56 (28%) and\n CVL<\/jats:styled-content>\n in 141 (72%). There were no baseline differences in age, sex, body mass index, American Society of Anesthesiologists score or pathological staging, and there were no major intra\u2010operative complications in either group (including no major vascular injuries). The median total number of nodes retrieved was 27 and 31 (\n P<\/jats:italic>\n \u00a0=\u00a00.011) in\n HL<\/jats:styled-content>\n and\n CVL<\/jats:styled-content>\n groups, resepctively, with pathologically positive nodes identified in 33.9% and 39.8% (\n P<\/jats:italic>\n \u00a0=\u00a00.704), respectively. Preoperative imaging identified abnormal\n cN<\/jats:styled-content>\n 3 nodes in 1.5% of patients; all of whom underwent\n CVL<\/jats:styled-content>\n . No abnormal\n cN<\/jats:styled-content>\n 2 or\n cN<\/jats:styled-content>\n 3 nodes remained on postoperative imaging. The 60\u2010day mortality was 0.5%, and major morbidity was 4%. One patient (0.5%) had an anastomotic recurrence after a median follow\u2010up of 22\u00a0months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n With imperfect preoperative clinical nodal staging, and in the absence of randomized data, the low morbidity and oncological outcomes observed support the approach of\n CME<\/jats:styled-content>\n with\n HL<\/jats:styled-content>\n as a minimum standard, with\n CVL<\/jats:styled-content>\n (D3 lymphadenectomy) in selected cases.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/codi.14794","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T13:03:15Z","timestamp":1564405395000},"page":"53-61","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Selective central vascular ligation (D3 lymphadenectomy) in patients undergoing minimally invasive complete mesocolic excision for colon cancer: optimizing the risk\u2013benefit equation"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4918-8871","authenticated-orcid":false,"given":"T.","family":"Sammour","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Malakorn","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Thampy","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. K.","family":"Bednarski","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. A.","family":"Messick","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Taggart","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. 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