Extent of lymphadenectomy in sigmoid colon cancer
10.3760/cma.j.cn441530-20250625-00241
- VernacularTitle:乙状结肠癌的淋巴结清扫范围
- Author:
Shengjie MA
1
;
Yuchen GUO
1
;
Liang HE
1
;
Quan WANG
1
Author Information
1. 吉林大学第一医院普外中心胃结直肠外科，长春 130021
- Publication Type:Journal Article
- Keywords:
Sigmoid colon neoplasms;
Lymphadenectomy;
Mesocolic excision;
Inferior mesenteric artery;
Fluorescence-guided navigation
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(9):999-1005
- CountryChina
- Language:Chinese
-
Abstract:
Complete mesocolic excision in radical colorectal cancer surgery enhances both surgical quality and the accuracy of pathological staging. In the context of sigmoid colon cancer, the optimal extent of lymphadenectomy and the appropriate level of vascular ligation remain controversial. High ligation of the inferior mesenteric artery may facilitate more thorough lymph node dissection and allow for tension-free anastomosis. However, it requires a comprehensive assessment of postoperative complication risks and the preservation of organ function. Para-aortic lymph node dissection has shown potential survival benefits in patients with oligometastatic disease, yet its application should be individualized. Moreover, intraoperative navigation technologies, such as indocyanine green fluorescence imaging, can assist in accurately delineating the dissection field and support the feasibility of personalized surgical strategies. This review synthesizes current evidence and leading domestic and international clinical guidelines to systematically examine the latest developments in lymphadenectomy strategies for sigmoid colon cancer, focusing on mesenteric anatomy, D3 dissection, complete mesocolic excision, vascular ligation levels, para-aortic lymph node dissection, and fluorescence-guided imaging techniques.
