| Title |
Defining minimal clearances for adequate lymphatic resection relevant to right colectomy for cancer: a post-mortem study
|
|---|---|
| Published in |
Surgical Endoscopy, February 2018
|
| DOI | 10.1007/s00464-018-6106-3 |
| Pubmed ID | |
| Authors |
Jens Marius Nesgaard, Bojan V. Stimec, Pricilla Soulie, Bjørn Edwin, Arne Bakka, Dejan Ignjatovic |
| Abstract |
There has been a lengthy discussion on the extent of lymphatic resection for right-sided colon cancer and the central borders of the mesentery that are not yet defined. The objectives of this study are to define minimal clearances for adequate lymphatic resection in regard to colic artery origins and the superior mesenteric artery (SMA) and vein (SMV) relevant to right colectomy. Central mesenteric lymph vessels, nodes, and blood vessels were dissected in 16 cadavers. Cranial-caudal clearances were defined as distances between an individual colic artery origin (ileocolic, right colic, and median colic artery) and the outermost lymphatic vessel within its lymphovascular bundle, cranial and caudal along the SMA. Long lymphatic vessels crossing the SMV between arterial bundles were counted and they constituted the medial clearances. An arbitrary watershed between small bowel and colonic lymph was localized. Immunohistochemistry was performed to histologically verify lymphatic vessels. Cranial-caudal clearances were ileocolic 3.6 ± 1.9 and 5.7 ± 1.9; right colic 2.8 ± 1.6 and 3.3 ± 1.0; middle colic artery bundle 6.3 ± 2.7 and 5.9 ± 2.4 mm, respectively. Long lymphatic vessels crossing the SMV between arterial buntles and approaching the SMA were found in all cadavers (antero/posteriorly in 12, only anteriorly in 4), median 3.5 (1-7) long lymphatic vessels anteriorly, and 1.5 (0-5) posteriorly per cadaver. Right colonic lymphovascular bundles are volumes of mesenteric tissue that surround the superior mesenteric vessels anteriorly and posteriorly. Long lymphatic vessels traverse the superior mesenteric vein anteriorly/posteriorly approaching the superior mesenteric artery between arterial bundles and placing the medial clearance on the left side of the artery. These do not correlate to arterial crossing patterns. Cranial-caudal clearances determine the tissue to be removed superior/inferior to arterial origins together with long lymphatic vessels transversing independently between the lymphovascular bundles placing the weight of lymphatic resection on the mesenteric tissue and not on the level of vessel division (High tie). |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 25% |
| Ireland | 2 | 17% |
| Luxembourg | 1 | 8% |
| Poland | 1 | 8% |
| Spain | 1 | 8% |
| Unknown | 4 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 33% |
| Science communicators (journalists, bloggers, editors) | 3 | 25% |
| Scientists | 3 | 25% |
| Practitioners (doctors, other healthcare professionals) | 2 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 19 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 19 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 4 | 21% |
| Lecturer | 2 | 11% |
| Student > Postgraduate | 2 | 11% |
| Student > Ph. D. Student | 1 | 5% |
| Professor | 1 | 5% |
| Other | 2 | 11% |
| Unknown | 7 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 47% |
| Neuroscience | 1 | 5% |
| Design | 1 | 5% |
| Unknown | 8 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 September 2023.
All research outputs
#5,231,281
of 25,503,365 outputs
Outputs from Surgical Endoscopy
#785
of 6,889 outputs
Outputs of similar age
#109,938
of 455,090 outputs
Outputs of similar age from Surgical Endoscopy
#27
of 120 outputs
Altmetric has tracked 25,503,365 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,889 research outputs from this source. They receive a mean Attention Score of 4.0. This one has done well, scoring higher than 88% of its peers.
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We're also able to compare this research output to 120 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 78% of its contemporaries.