Hotspots and controversies in the infrapyloric lymph node dissection for right colon cancer / 中华消化外科杂志

ABSTRACT

The incidence and proportion of right colon cancer is increasingly high in recent years with a relatively poor prognosis. Right hemicolectomy is the standard procedure for the treatment of right colon cancer. Recently, infrapyloric lymph node (No.206 nodes) dissection has become one of the hot topics of surgical treatment for right colon cancer. The incidence of infrapyloric lymph node metastasis is still unclear, and whether it belongs to the regional lymph node of the right colon cancer is controversial. There are few methods to judge and predict infrapyloric lymph node metastasis, and the accuracy of diagnosis is low. What's more, dissection of infrapyloric lymph node might increase the risk of complications and perioperative mortality, as well as lead to overtreatment. As a result, this series of problems and controversies result in the obscure of the clinical value of infrapyloric lymph node dissection. Therefore, there is urgent need to design more high-quality, multicenter and large-sample prospective randomized controlled trials to explore the standard of routine dissection of infrapyloric lymph node for right colon cancer. Based on research advances at home and abroad, the authors review the incidence of infrapyloric lymph node metastasis, methods for judgement of infrapyloric lymph node metastasis, inluencing factors for lymph node metastasis, value of lymph node dissection, and research of direction in the future.