Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.528
Peer-review started: June 22, 2021
First decision: September 28, 2021
Revised: September 29, 2021
Accepted: December 10, 2021
Article in press: December 10, 2021
Published online: January 14, 2022
Processing time: 203 Days and 15.9 Hours
Currently, the standard surgical procedure for right colon cancer is complete mesocolic excision. Whether preventive extended lymph node dissection for colon cancer located in the hepatic flexure or right transverse colon should be performed remains controversial because the safety and effectiveness of the operation have not been proven, and infrapyloric lymph nodes (No. 206) and lymph nodes in the greater curvature of the stomach (No. 204) have not been strictly defined and distinguished as surgical indicators in previous studies.
To analyze the metastatic status of infrapyloric lymph nodes and lymph nodes of the greater curvature of the stomach and perioperative complications and systematically evaluate the feasibility and safety of laparoscopic extended right colectomy using prospective data collected retrospectively.
The study was a clinical study. Twenty patients with colon cancer who underwent laparoscopic extended right colon resection in our hospital from June 2020 to May 2021 were included.
Among the patients who underwent extended right colon resection, there were no intraoperative complications or conversion to laparotomy; 2 patients had gastrocolic ligament lymph node metastasis, and 5 patients had postoperative complications. The patients with postoperative complications received conservative treatment.
Laparoscopic extended right colon resection is safe. However, malignant tumors located in the liver flexure or the right-side transverse colon are more likely to metastasize to the gastrocolic ligament lymph nodes, and notably, the incidence of gastroparesis was high. The number of patients was small, and the follow-up time was short. It is necessary to further increase the sample size to evaluate the No. 204 and No. 206 lymph node metastasis rates and the long-term survival impact.
Core Tip: Whether laparoscopic extended right colectomy should be performed in patients with malignant tumors located in the hepatic flexure and right-side transverse colon remains controversial mainly because of the lack of an understanding of lymph node metastasis in the gastrocolic ligament and doubts regarding the safety of the operation. No prospective studies assessed the possibility and safety of laparoscopic extended right colon resection. Although the sample size in this article was small, the cases were strictly screened and had a certain degree of representativeness, which can provide some insight to surgeons.