{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T04:05:51Z","timestamp":1745035551325,"version":"3.40.4"},"reference-count":22,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"crossref","award":["2023A1515010347","2021A1515011827"],"award-info":[{"award-number":["2023A1515010347","2021A1515011827"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>The optimal extent of lymph node dissection in right hemicolectomy for colon cancer remains a topic of debate. This study aimed to refine lymph node dissection strategies by investigating the histopathological characteristics of the anterior tissue of the superior mesenteric vein (SMV) surgical trunk.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Methods<\/jats:title>\n               <jats:p>One hundred sixty-two patients underwent surgery, with their medial resection border determined to be either to the right or left of the SMV. Pathological and perioperative variables were assessed, and the anterior tissue of the SMV was analyzed to quantify lymph nodes and nerve fibers.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>Of the patients included, 84 were in the SMV-right group and 78 in the SMV-left group. After propensity score matching (PSM), the SMV-left group with dissection extending to the left side of the SMV and removal of the anterior tissue of SMV surgical trunk, retrieved more lymph nodes (36.9 <jats:italic>vs.<\/jats:italic> 26.8, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) than the SMV-right group. However, there was no difference in node-positive staging. The SMV-left group also experienced more postoperative complications (16.7% <jats:italic>vs.<\/jats:italic> 1.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.011) and prolonged postoperative defecation times (4.2 <jats:italic>vs.<\/jats:italic> 3.5, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.035), accompanied by a higher resection of nerve fibers (12.1 \u00b1\u00a04.2\/case). Multivariate analysis identified tumor location above the ileocolic vein (ICV) root and elevated preoperative CA 19-9 levels as independent risk factors for metastasis to main lymph nodes.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusion<\/jats:title>\n               <jats:p>Right hemicolectomy with extended lymph node dissection improves lymph node retrieval but increases complication risks and prolongs bowel recovery time. For patients with tumors located below the ICV root, a more limited dissection with the right side of the SMV as the medial boundary may be a preferable option, given the low rate of main lymph node metastasis.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.19290","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T08:27:41Z","timestamp":1744964861000},"page":"e19290","source":"Crossref","is-referenced-by-count":0,"title":["Tailored lymph node dissection in right hemicolectomy: a retrospective study focusing on the anterior tissue of the superior mesenteric vein surgical trunk"],"prefix":"10.7717","volume":"13","author":[{"given":"Xianda","family":"Chi","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 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