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 T2-3 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.
关键词
结肠肿瘤/腹腔镜/D3淋巴结清扫/右半结肠癌根治术
Key words
Colonic Neoplasms/Laparoscopes/D3 Lymphadenectomy/Radical Right Hemicolectomy
维普
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