The right hemicolon fascial system: a narrative review - Report - MDSpire

The right hemicolon fascial system: a narrative review

  • By

  • Zhiping Huang

  • Xumu Shen

  • Ping Chen

  • Wei Zhang

  • May 11, 2026

  • 0 min

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Clinical Report: The Fascial System of the Right Hemicolon: A Comprehensive Review

Overview

This review highlights the significance of understanding the fascial system of the right hemicolon in colorectal surgery. It emphasizes the importance of complete mesocolic excision (CME) for improving patient outcomes, while addressing the existing controversies in terminology and anatomical understanding.

Background

Colorectal cancer is a leading cause of cancer-related mortality worldwide, necessitating advancements in surgical techniques. The shift towards membrane anatomy in surgical practices aims to enhance the precision of procedures such as total mesorectal excision (TME) and complete mesocolic excision (CME). A thorough understanding of the right hemicolon fascial system is critical for optimizing surgical outcomes and minimizing complications.

Data Highlights

No numerical data available in the article.

Key Findings

  • The complete excision of the mesentery is crucial for the prognosis of colorectal cancer patients.
  • Controversies exist regarding the understanding of the abdominal fascial system in right colon cancer surgery.
  • Terminological inconsistencies hinder effective communication and understanding among healthcare professionals.
  • The concept of fusion space is proposed as a practical approach in surgical practice.
  • Advancements in surgical techniques have improved the 5-year survival rates for colorectal cancer patients.

Clinical Implications

Surgeons should prioritize a comprehensive understanding of the right hemicolon fascial system to enhance surgical precision. Addressing the terminological inconsistencies in fascia nomenclature may improve communication and training in colorectal surgery.

Conclusion

A thorough review of the right hemicolon fascial system is essential for improving surgical outcomes in colorectal cancer. Continued education and standardization of terminology will facilitate better surgical practices.

Related Resources & Content

  1. Laparoscopic Extended Left Hemicolectomy with CME and Transverse-Rectal Anastomosis for Long Splenic Flexure Carcinoma: A Five-Step Approach to Modified Partial Deloyers Technique for Optimal Reach and Preservation of Middle Colic Vessels, Springer, 2021
  2. The Rectogenital Fascia: An Examination of Denonvilliers’ and Pattison’s Contributions to Its Historical, Anatomical, Embryological, and Surgical Contexts - Part Three: Surgical Utilization of the Pattison-Denonvilliers Rectogenital Fascia, BJS, 2023
  3. The Rectogenital Fascia: A Comparative Study of Denonvilliers and Pattison - Part Two: Anatomical and Embryological Insights into the Pattison-Denonvilliers Fascia, BJS, 2023
  4. Optimizing the Surgical Field for Right-Sided Colon Cancer Mobilization via a Duodenum-First Multidirectional Technique in Laparoscopic Procedures, Techniques in Coloproctology, 2021
  5. Guideline EAES Rapid Guideline: Complete mesocolic excision for right-sided colon cancer – with SAGES and ESCP participation, EAES, 2025
  6. A Randomized Phase III Trial of Complete Mesocolic Excision Compared with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-in trial), BJS Open, 2023
  7. Guideline EAES Rapid Guideline: Complete mesocolic excision for right-sided colon cancer – with SAGES and ESCP participation
  8. A Randomized Phase III Trial of Complete Mesocolic Excision Compared with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-in trial)
  9. https://academic.oup.com/bjsopen/article/9/3/zraf066/8160838

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