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Updated: May 18, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

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Lymph node harvest in emergent versus elective colon resections.

Aaron Lewis¹, Gabriel Akopian, Sharon Carillo

¹Huntington Hospital, Pasadena, California 91105, USA.

The American Surgeon

|October 3, 2012

Summary

Emergent surgery for colon cancer does not lead to fewer lymph nodes removed compared to elective procedures. This study found no difference in lymph node harvest adequacy between emergent and elective colon cancer surgeries.

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Area of Science:

Oncology
Surgical Pathology
Clinical Outcomes

Background:

Adequate lymph node harvest is a critical quality measure for colon cancer prognostication.
Emergent surgery, often performed for complications like obstruction or perforation, is perceived to potentially compromise surgical quality, including lymphadenectomy.

Purpose of the Study:

To investigate the association between emergent surgery and lymph node harvest adequacy in colon cancer patients.
To compare lymph node yield in emergent versus elective colon cancer resections.

Main Methods:

Retrospective analysis of the National Cancer Database (NCDB) for colon cancer patients undergoing resection between 2005 and 2010.
Inclusion of demographic data, surgical indication, stage, lymph node harvest, tumor location, surgical method, chemotherapy, and survival.

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Last Updated: May 18, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection

Published on: January 9, 2026

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

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Published on: March 24, 2023

Univariate analyses to compare lymph node harvest rates between emergent and elective surgery groups.

Main Results:

No statistically significant difference in adequate lymph node harvest rates between emergent (86.0%) and elective (88.1%) colectomies.
Inferior long-term survival was associated with both emergent indication and inadequate lymph node harvest.
A trend of increasing lymph node harvest adequacy was observed over time, from 79.5% in 2005 to 95.5% in 2010.

Conclusions:

Contrary to perception, emergent colon cancer surgery at this institution was not associated with inferior lymph node harvests.
Adequate lymphadenectomy can be achieved in both emergent and elective settings for colon cancer.
Surgical quality, specifically lymph node yield, appears to be maintained even in emergent colectomies.