This meta-analysis aims to evaluate the role of complete mesocolic excision (CME) in the surgical treatment of right-sided colon cancer, compared to standard right hemicolectomy, with a focus on oncological outcomes and procedural safety.Materials and Methods A systematic literature search was conducted using Scopus, ScienceDirect, PubMed, and the Cochrane Library databases to identify relevant studies published between 1 January 2005 and 1 March 2025. Eligible studies included cohort studies that compared an intervention group treated with CME and a control group treated with non-CME (nCME) procedures. The primary outcomes assessed were overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS). Secondary outcomes included the total number of lymph nodes harvested, postoperative hospital stay, and the incidence of postoperative surgical complications. ResultsThe three-year DFS was superior in the CME group (85.7%) with respect to the conventional right-side colectomy group (76.5%) (OR=1.59, 95% CI=1.24–2.04). The five-year DFS was superior in the CME group (88.0%) with respect to the conventional right-side colectomy group (80.4%), (OR=2.09, 95% CI=1.56–2.81). The five-year OS was superior in the CME group (83.2%) with respect to the conventional right-side colectomy group (75.2%) (OR=1.58, 95% CI=1.18–2.11). No difference was found between right-side colectomy with CME and nCME for overall post-operative complications (OR=0.98), for surgical post-operative complications (OR=1.11) and for non-surgical post-operative complications (OR=0.88). Anastomotic leakage (OR=1.02), postoperative ileus (OR=1.17), mean hospital duration (MD=-0.57 days) and mean blood loss (MD=-33.9) also reveal no difference in CME vs. non-CME. On the other hand, the number of harvested lymph nodes, 30.0±12.5 lymph nodes after CME surgery and 23.0±10.3 lymph nodes after non-CME surgery (MD=6.56). Conclusions The findings clearly demonstrate that CME is associated with superior primary oncological outcomes, showing significantly improved 3- and 5-year OS and DFS compared to conventional right-sided colectomy. Importantly, CME does not appear to increase perioperative morbidity, as no significant differences were observed between groups in terms of intraoperative blood loss, anastomotic leakage, postoperative ileus, or length of hospital stay. Taken together, these results support the growing consensus that CME should be considered the preferred surgical technique for the treatment of right-sided
Ιωάννα Ευαγγελία Δ. Τσιούρβα (Wed,) studied this question.