Indication of Laparoscopy-assisted Colectomy and Para-aortic Lymph Node Dissection in Right Colon Cancer

We investigated histopathologic findings and lymph node recurrence in right colon cancer to evaluate the indication for laparoscopy-assisted colectomy and para-aortic lymph node dissection. Forty-six patients who had undergone curative resection for right colon cancer in a recent one decade were studied. Tumors with invasion into the colonic wall no deeper than the proper muscle layer (n = 13) were not associated with lymph node metastasis. Patients whose primary lesions were smaller than 20 mm in maximum diameter had no lymph node metastasis. Patients with 0 or 1 macroscopic type also had no lymph node metastasis. These patients may be candidates for laparoscopy-assisted colectomy. Lymph node metastases of n0, n1, n2, and n3 were observed in 28, 4, 13, and I patients, respectively. All of 8 patients who experienced tumor recurrence had n2 or n3 lymph node metastasis. Out of these 8 patients, 2 patients had only para-aortic lymph node recurrence. Preventive para-aortic lymph node dissection is therefore suitable for right colon cancer with n2 or n3 lymph node metastasis.

右側結腸癌

術式の選択

腹腔鏡下手術

傍大静脈リンパ節郭清