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Updated: Jun 22, 2026
Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Does a laparoscopic approach affect the number of lymph nodes harvested during curative surgery for colorectal
Galal El-Gazzaz1, Tracy Hull, Jeffery Hammel
1A30 Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Background:
This study aimed to assess the number of lymph nodes (LNs) harvested after laparoscopic and open colorectal cancer resections.
Methods:
Between 1996 and 2007, 431 colorectal cancer patients underwent laparoscopic resection. During the periods of 1996-1997, 2002-2003, and 2006-2007, 243 patients undergoing laparoscopic colorectal cancer resection were matched 1-2 by age, operation, gender, operation date, body mass index (BMI), and tumor stage (TNM) to 486 patients undergoing open surgery. The numbers of examined and involved LNs were compared according to tumor location and year of surgery.
Results:
Colorectal cancer resections (243 laparoscopic and 486 open procedures) were performed for 729 patients (447 men) with a mean age of 66.2 +/- 12.3 years and a mean BMI of 28.5 +/- 7.3. The mean number of LNs per case was 24.8 +/- 20.6. The number of LNs retrieved did not differ between laparoscopic and open surgery (p = 0.4). A significant difference was observed between the number of involved LNs retrieved laparoscopically (2.2 +/- 3.8) and the number retrieved by open surgery (1.6 +/- 4; p = 0.03). There were significant differences between the numbers of LNs retrieved from the right colon (28.1 +/- 14.6), left colon (24.5 +/- 17.6), and rectum (19.1 +/- 15.1) (p < 0.001). There were significantly fewer examined LNs in laparoscopic than in open cases during 2002 and 2003 (p = 0.003).
Conclusion:
Laparoscopic resection of colorectal cancer can achieve lymph node retrieval similar to that achieved by the open approach. In this era of new technology, laparoscopic lymph node harvest is becoming more optimized.
