{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:55:54Z","timestamp":1747184154723,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,22]],"date-time":"2022-10-22T00:00:00Z","timestamp":1666396800000},"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":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this work is to describe a protocol and assess the feasibility of harvesting and analysing the mesocolic apical fragment (MAF) for the presence of central lymph node (LN) metastasis and extra lymphatic free tumour cells in a random subgroup extracted from a cohort of complete mesocolic excision colectomies with central vascular ligation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Forty\u2010seven patients diagnosed with colorectal cancer were included. A 2\/2\u00a0cm pyramid of tissue was cut around the central tie and sent for pathological examination. The MAF was sectioned into 16 slices. High\u2010definition images were taken from the slices which were merged into a panoramic three\u2010dimensional image of the MAF. The distribution of LNs in the MAF was quantified. Immunohistochemistry staining for cytokeratin 14 was used to identify isolated tumour cells and micrometastases in the extranodal tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No tumoural cells migrating through the apical zone, outside of the LNs, were identified. Margins of resection, mesocolic tissue and LNs were all negative in the subgroup of ultrastaged MAFs. The number of examined central LNs varied between 0 and 24, with positive MAF LNs being identified only in pN2 stages. The rate of positive apical LNs in our cohort was 4.2% (<jats:italic>n<\/jats:italic>\u00a0=\u00a02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The MAF can be easily extracted from standard specimens, allowing for accurate analysis of lymphatic and extra\u2010nodal tumour cells on the central resection margins, in central LNs and in the apical mesocolic tissue. Future research on larger cohorts is required to establish if analysing the MAF has an impact on patient staging, prognosis and management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16362","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T13:42:26Z","timestamp":1665668546000},"page":"234-242","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The mesocolic apical fragment in complete mesocolic excision colectomies: Should it be analysed separately? A proof\u2010of\u2010concept study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-4058","authenticated-orcid":false,"given":"Cristian","family":"Livadaru","sequence":"first","affiliation":[{"name":"Radiology and Medical Imaging Department St Spiridon University Hospital  Ia\u0219i Romania"},{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7767-0975","authenticated-orcid":false,"given":"Stefan","family":"Morarasu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Bargaoanu","sequence":"additional","affiliation":[{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Iacob","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor","family":"Frunza","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Musina","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Velenciuc","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian Ene","family":"Roata","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florin","family":"Zugun\u2010Eloae","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"Center of Fundamental Research and Experimental Development in Translational Medicine at Regional Institute of Oncology Regional Institute of Oncology (IRO)  Iasi Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Ferariu","sequence":"additional","affiliation":[{"name":"Department of Pathology Regional Institute of Oncology (IRO)  Iasi Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorinel","family":"Lunca","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy  Ia\u0219i Romania"},{"name":"2nd Department of Surgical Oncology Regional Institute of Oncology (IRO)  Ia\u0219i Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihail\u2010Gabriel","family":"Dimofte","sequence":"additional","affiliation":[{"name":"Grigore T. 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