J.Jpn. Surg. Soc.
ISSN 1880-1129

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J.Jpn. Surg. Soc.. 123(3): 228-233, 2022

Feature topic

EXTENT OF LYMPH NODE DISSECTION FOR COLON CANCER:A COMPARISON BETWEEN D3 DISSECTION AND COMPLETE MESOCOLIC EXCISION

Department of Surgery, Teikyo University Hospital, Mizonokuchi, Kawasaki, Japan

Hirotoshi Kobayashi, Junpei Takashima, Yuta Suzuki, Ayaka Koizumi, Fumi Shigehara, Mitsuo Tsukamoto, Kenji Yamazaki, Hitoshi Sugimoto, Daisuke Fujimoto, Fumihiko Miura, Keizo Taniguchi, Noriyuki Matsutani

D3 lymph node dissection is a standard procedure for T3–T4 colon cancer in Japan. On the other hand, complete mesocolic excision with central vascular ligation (CME + CVL) has been widely adopted in other countries since Hohenberger et al. proposed this concept in 2009. For both techniques, sharp dissection along the embryological plane and ligation of the supplying vessels at their origin are essential. However, there is a difference in the length of the resected specimen between the two procedures. In D3 dissection, both proximal and distal margins should be 10 cm beyond the tumor to remove the regional lymph nodes. Meanwhile, the length of the resected specimen in CME +CVL is approximately 1.5–2.5 times greater than that in D3 dissection.

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