SYSTEMATIC REVIEW article
Front. Surg.
Sec. Surgical Oncology
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1651549
This article is part of the Research TopicEvaluating surgical techniques and perioperative strategies in colorectal cancer treatmentView all 5 articles
Exploration of the Medial Border for Laparoscopic D3 Lymph Node Dissection in Right Hemi-Colon Cancer: A Systematic Review and Meta-analysis
Provisionally accepted
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Introduction: The optimal medial boundary for lymph node dissection during laparoscopic radical right hemicolectomy for colorectal cancer remains uncertain. We investigated whether the superior mesenteric artery (SMA) or superior mesenteric vein (SMV) should serve as the medial border for D3 lymph node dissection in right hemicolon cancer. Methods: We systematically searched the Cochrane Library, EMBASE, CNKI, VIP, Wanfang, ClinicalTrials.gov, and SinoMed databases through March 2024. Studies comparing SMA- and SMV-based medial borders were included according to predefined criteria. Outcomes analyzed included intraoperative parameters, postoperative recovery, lymph node yield, complications, and survival. Results: Compared with the SMV group, the SMA group had more lymph nodes cleared (P=0.001) and more positive nodes retrieved (P=0.04), but also longer postoperative drain placement (P=0.01). Intraoperative bleeding was higher in the SMV group (P=0.01). Meta-analysis of patients' postoperative overall survival (P=0.927) and recurrence-free survival (P=0.949) showed no significant differences in short-term prognosis between the two groups. Discussion: Using the SMA’s left border for laparoscopic D3 dissection is safe and feasible, providing higher lymph node yield without increasing major complications. However, this greater yield did not translate into improved short-term survival. The long-term prognostic effect of the SMA approach requires further investigation.
Keywords: medial border, Laparoscopic, D3 lymph node dissection, right hemi-colon cancer, Meta-analysis
Received: 22 Jun 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Li, Xin, Chen and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: He Han, 514354713@qq.com
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