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Table 1 CME vs. Japanese D3 vs. mCME

From: Prospective study of oncologic outcomes after laparoscopic modified complete mesocolic excision for non-metastatic right colon cancer (PIONEER study): study protocol of a multicentre single-arm trial

 

The original CME [2,3,4]

Japanese D3 [6, 14]

mCME [10]

Dissection plane

Embryologic tissue plane between retroperitoneal fascia and mesocolic fascia

Along with the layers of fusion fascia

Embryologic tissue plane respected, but obtaining secure radial margin weighed more

Tailored lymphadenectomy

Not mentioned

Tailored according to tumor location and stage

Tailored according to tumor location and stage

Extra-mesocolic lymphadenectomy

Recommended

Not recommended

Not recommended

Securing radial margin

Not clearly mentioned

Not clearly mentioned

Very important

Surgical quality assessment

Specimen grading, morphometry

Not clearly mentioned

Specimen grading as well as surgical field photo documentation after specimen removal

Proximal & distal resection margin

Not mentioned, but wide enough bowel resection length

10-cm rule

Bowel resection length determined by tailored lymphadenectomy

  1. a Gastroepiploic, gastrocolic trunk nodes, lymphatic tissue in pancreas capsule and other lymph nodes that are not contained in mesocolon