ICG-assisted D3 lymphadenectomy in right colectomy for cancer

The principles of oncologic resection for colon cancer are based on primary tumor excision associated with blood supply and lymph node (LN) drainage (1). Resection of the tumor and its vessels are relatively standardized, while the extent of the mesenteric lymphadenectomy can be variable. This topic can affect the quality of specimen, the nodal yield and potentially the survival outcomes for the patient through under-staging (2). From literature we know that the distribution pattern of LNs metastasis in resected specimens is extremely variable. The first metastatic node was found in the pericolic area outside 5 cm from the tumor in 18% of cases (3). Patients with cecal and ascending colon cancer had most frequently metastasis in the ileocolic LNs, while the LNs metastasis along the right branch of the middle colic artery (MCA) occurred only in 6.1% of patients with cecal cancer (4). Original Article

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