关键词: 结肠肝曲, 结肠肿瘤, D3根治术, 完整结肠系膜切除, 幽门下淋巴结, 淋巴结清扫

Abstract: The meaning and controversy of infrapyloric lymph node dissection in the advanced colonic hepatic flexure cancer           WANG Zhen-ning，JIANG Cheng-gang. Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors （Ministry of Education）, the First Affiliated Hospital of China Medical University，Shenyang 110001，China
Corresponding author：WANG Zhen-ning，E-mail：josieon826@
sina.cn
Abstract    Although the proportion of colonic hepatic carcinoma in colon cancer is relatively small，due to its anatomical location and pathological characteristics，it has a higher recurrence rate，and infrapyloric lymph node metastasis is more common.Whether and when to perform infrapyloric lymph node dissection during radical D3 colon cancer surgery is an important clinical problem that perplex many surgeons.The D3 and CME procedures for right colon cancer are currently two widely accepted concepts in right hemicolectomy，and they can also achieve a considerable prognosis. Colonic hepatic flexure cancer sometimes requires infrapyloric lymph node dissection at the same time as radical hemicolectomy.The surrounding anatomy of hepatic flexure cancer is complicated，and the operation is more difficult than D3 radical operation. Different physicians have different treatments for colonic hepatic carcinoma. At present，there are relatively few reports of infrapyloric lymph node dissection of colonic hepatic carcinoma，and the specific benefit situation still lacks targeted evaluation.

Key words: hepatic flexure, colonic neoplasms, D3 radical operation, complete mesocolic excision, infrapyloric lymph nodes, lymph node dissection