FIGURE LEGENDS (Supplemental Material)

FIGURE LEGENDS (supplemental material)

Figure 1. (A) Extent of D3 lymph node dissection for patients with clinically stage III right-sided colon cancer. (B) The ileocolic artery (ICA) and vein (ICV), right colic artery (RCA), and middle colic artery (MCA) relevant to D3 lymph node dissection were skeletonized and transected at their junction with superior mesenteric artery (SMA) and vein (SMV). (C) Technically, the ICA and ICV were initially tented to expose the avascular mesenteric groove, which is considered as the best starting point for conducting the present procedures. (D) Subsequently, The SMV was denuded upward with the stripping of ICV and ICA, which runs dorsally. (E) Mostly, the RCA arises from the right branch of MCA. All these vessels were ligated and transected at their origins. (F) The venous structures related to D3 lymph node dissection, including gastroepiploic vein (GEPV), accessory right colic vein (Ass. RCV), and Henle’s gastrocolic trunk (GCT) were denuded to their confluence point with SMV.

Figure 2. In performing complete mesocolic resection, the mesentery was tented ventrally and retroperitoneal dissection was performed along the pre-renal fascia with clear exposure of Gerota fascia, duodenum, and inferior vena cava (A), and then, the retroperitoneal dissection was developed upward and laterally to the sub-hepatic peritoneal reflection (B).

Table 1. (Supplemental material) Comparison of recurrence patterns among pathologic N0-N3 groups of patients with right-sided colon cancer treated by laparoscopic D3 lymph-node dissection
N0(n=42) / N1(n=80) / N2(n=74) / N3(n=48) / P-value
Total / 7(16.6%) / 17(21.3%) / 32(43.2%) / 25(52.0%) / NS
Liver metastasis only / 1 / 3 / 5 / 2
Lung metastasis only / 0 / 1 / 3 / 2
Bone metastasis only / 0 / 1 / 2 / 0
Lymph node metastasis (abdomen, neck) / 1 / 2 / 5 / 4
Unusual metastasis / 0 / 1 / 2 / 3
Brain metastasis / 0 / 1 / 0 / 1
Spleen metastasis / 0 / 0 / 1 / 0
Skin metastasis / 0 / 0 / 1 / 1
Adrenal metastasis / 0 / 0 / 0 / 1
Peritoneal carcinomatosis / 1 / 2 / 4 / 3
Multiple organ metastases / 4 / 6 / 11 / 11
Liver + Lung / 1 / 2 / 4 / 4
Liver + Bone / 1 / 1 / 2 / 2
Lung + Bone / 0 / 1 / 1 / 2
Liver + Peritoneum / 2 / 2 / 4 / 3

* The calculation of p-value was based on the comparison of headings of recurrence by Fisher’s exact test. The subheadings of recurrence were lumped together and compared; NS: not significant, p>0.05

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