Laparoscopic Complete Mesocolic Excision with Extended D3 Lymphadenectomy for Advanced Hepatic Flexure Cancer: Addressing Infrapyloric Node Dissection - a video vignette.
Guglielmo Niccolò PiozziJi-Seon KimTae-Hoon LeeJeong Min ChooSeon Hui ShinSeon Hahn KimPublished in: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (2021)
Complete mesocolic excision (CME) has improved overall survival and local recurrence of colon cancer[1]. Transverse colon, including hepatic flexure, is intertwined with the gastrocolic ligament and the greater omentum with small blood and lymphatic vessels crossing the embryological interface[2], allowing tumour cells to migrate from the colon to the infrapyloric and gastroepiploic lymph nodes (IGLN)[3]. There is no recommendation in current guidelines about IGLN routine dissection for hepatic flexure/transverse colon tumours. Few authors have reported IGLN metastases rates from colonic tumours (range 0.7-22.0%)[4-11]. Routine IGLN dissection could increase morbidity and mortality[5].There is no current standardization of IGLN dissection for colon cancers and whether IGLN+ impacts on N[5, 10] or M stage[8, 9, 12].
Keyphrases
- lymph node
- clinical practice
- sentinel lymph node
- induced apoptosis
- robot assisted
- neoadjuvant chemotherapy
- papillary thyroid
- early stage
- free survival
- cell cycle arrest
- lymph node metastasis
- cell proliferation
- signaling pathway
- endoplasmic reticulum stress
- squamous cell carcinoma
- oxidative stress
- young adults
- minimally invasive