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Background <p>Complete mesocolic excision (CME) is increasingly recognized as a&#xa0;standard surgical approach in colon cancer, offering improved oncologic outcomes through dissection along embryological planes and central vascular ligation. However, the relevance of complete lymphadenectomy at the trunk of Henle remains unclear. This study aimed to determine the incidence of radiologically detectable lymph node metastases at the trunk of Henle in patients undergoing standardized conventional right hemicolectomy without formal CME.</p> Methods <p>In this retrospective single-center study, follow-up data were analyzed for 234 patients who underwent standardized right hemicolectomy for right-sided colon cancer without CME. Demographic, surgical, and pathological data were extracted from electronic records. Annual contrast-enhanced computed tomography (CT) scans were performed postoperatively and independently reviewed by two board-certified radiologists, focusing on lymphatic recurrence near the trunk of Henle.</p> Results <p>Of the 218 patients included in the final analysis, 45&#xa0;patients (20.6%) developed recurrent colon cancer during follow-up. Among these, five patients (2.3%) showed radiologically enlarged lymph nodes in the region of the trunk of Henle, suggestive of locoregional lymphatic recurrence.</p> Conclusion <p>Locoregional lymphatic recurrence at the trunk of Henle following right hemicolectomy for colon cancer is radiologically observed in only a&#xa0;small subset of patients. Therefore, omitting radical lymphadenectomy in this region may be a&#xa0;reasonable consideration in selected cases—particularly when the anticipated risk of extended dissection exceeds its potential oncologic benefit.</p>

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Lymph node metastases at the trunk of Henle

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Andreas Lorenz,
  • Ferdinand Fink,
  • Eva Maria Gassner,
  • Elisabeth Gasser,
  • Dietmar Öfner

摘要

Background

Complete mesocolic excision (CME) is increasingly recognized as a standard surgical approach in colon cancer, offering improved oncologic outcomes through dissection along embryological planes and central vascular ligation. However, the relevance of complete lymphadenectomy at the trunk of Henle remains unclear. This study aimed to determine the incidence of radiologically detectable lymph node metastases at the trunk of Henle in patients undergoing standardized conventional right hemicolectomy without formal CME.

Methods

In this retrospective single-center study, follow-up data were analyzed for 234 patients who underwent standardized right hemicolectomy for right-sided colon cancer without CME. Demographic, surgical, and pathological data were extracted from electronic records. Annual contrast-enhanced computed tomography (CT) scans were performed postoperatively and independently reviewed by two board-certified radiologists, focusing on lymphatic recurrence near the trunk of Henle.

Results

Of the 218 patients included in the final analysis, 45 patients (20.6%) developed recurrent colon cancer during follow-up. Among these, five patients (2.3%) showed radiologically enlarged lymph nodes in the region of the trunk of Henle, suggestive of locoregional lymphatic recurrence.

Conclusion

Locoregional lymphatic recurrence at the trunk of Henle following right hemicolectomy for colon cancer is radiologically observed in only a small subset of patients. Therefore, omitting radical lymphadenectomy in this region may be a reasonable consideration in selected cases—particularly when the anticipated risk of extended dissection exceeds its potential oncologic benefit.