Abstract:

The concept and technique of complete mesocolectomy combined with D2 or D3 lymph node dissection is widely accepted. Laparoscopic D3 lymph node dissection of laparoscopic right hemicolectomy included parenteral lymph nodes, intermediate lymph nodes and central lymph nodes. In practice, the specific extent of dissection has not been clearly defined, which is mainly reflected in the medial border of central lymph node dissection and the lymph node dissection in the subpyloric region. We suggest that the medial border of central lymph node dissection should be determined individually. Patients with clinical stage T_2-3 could use the left side of Superior Mesenteric Vein(SMV) as the medial border, and patients with clinical stage T₄ or SMV with enlarged lymph nodes on the surface should use the Superior Mesenteric Artery(SMA) midline as the inner border for lymph node dissection. In addition, accurate staging before surgery, reasonable surgical approach, intraoperative lymph node tracing technique, and superior mesenteric plexus protection technique can assist in more accurate and safe D3 lymph node dissection.

Key words: Colonic Neoplasms, Laparoscopes, D3 Lymphadenectomy, Radical Right Hemicolectomy