D3 lymphadenectomy for right colon cancer

Marcin Włodarczyk, Jakub Włodarczyk, Radzisław Trzciński, Michał Mik, Łukasz Dziki, Adam Dziki


Extension of lymphadenectomy in case of right-sided colon cancer surgery is recently broadly discussed. Since the introduction of complete mesocolic excision (CME) with central lymph node resection or lymphadenectomy D3, a number of studies were undertaken to assess the beneficial role of these procedures on overall survival in colon cancer patients. While it is generally known that the number of dissected lymph nodes during cancer-related operation is associated with a better prognosis on overall survival, the results of studies on CME with central lymph node resection or D3 lymphadenectomy are inconclusive. The greater number of harvested lymph nodes warrants positive outcome, however, not every study confirms overall survival improvement. Extended lymphadenectomy has also been associated with a higher number of complications, compared to conventional resection of colonic cancer. In this review, we focus on the detailed description of the surgical technique for D3 lymphadenectomy in the right-sided colorectal cancer (CRC) patients as well as provide a critical appraisal of the quality of the available data in the current literature.