Background: Small bowel neuroendocrine tumors (NETs) represent rare gastrointestinal malignancies with complex lymphatic dissemination. Although lymphadenectomy is central to curative surgery, its extent and terminology remain poorly standardized. This scoping review evaluates the anatomical variability of lymphadenectomy and nodal outcomes in small bowel NET surgery.

Methods: A literature review was conducted using PubMed, Scopus, Web of Science, and Embase to identify studies published between January 2005 and December 2025. Only English-language studies reporting surgical management of jejunal and ileal NETs were included. Duodenal tumors were excluded. The reported extent of lymphadenectomy was evaluated across all eligible studies, and lymph node yield (LNY) data were descriptively pooled without formal meta-analysis.

Results: Out of 680 screened studies, 16 studies were analyzed, encompassing series limited to NETs of the jejunum and ileum. Marked heterogeneity was observed in both the extent and terminology of lymphadenectomy. The level of dissection was identified in 12 articles, and only three articles discussed tumor feeding vessel ligation. Reported nodal yields ranged widely, with a pooled mean of 13.2 lymph nodes (LNs), while the lymph node ratio (LNR) varied from 0.14 to 0.72 across series. Terms such as “regional”, “locoregional”, and “extended” lymphadenectomy were inconsistently applied and lacked anatomical reproducibility.

Conclusions: The literature on small bowel NET surgery demonstrates substantial heterogeneity in the extent and reporting of lymphadenectomy, limiting cross-study comparability. Given the frequent involvement of central mesenteric LNs, this scoping review, based on the available literature and anatomical principles, proposes a conceptual framework for standardized reporting of lymphadenectomy extent, including D3-volume lymphadenectomy guided by individualized vascular anatomy, while acknowledging the need for prospective validation.