Radical resection with autonomic nerve preservation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection

1998 ◽  
Vol 383 (6) ◽  
pp. 409-415 ◽  
Author(s):  
T. Mori ◽  
K. Takahashi ◽  
M. Yasuno
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Radical Resection ◽  
Autonomic Nerve ◽  
Lower Rectal Cancer ◽  
Rectal Cancer Surgery ◽  
Node Dissection ◽  
Lateral Lymph Node ◽  
Nerve Preservation ◽  
The Impact

scholarly journals Lateral lymph node dissection reduces local recurrence of locally advanced lower rectal cancer in the absence of preoperative neoadjuvant chemoradiotherapy: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiang Gao ◽  
Cun Wang ◽  
Yong-Yang Yu ◽  
Dujanand Singh ◽  
Lie Yang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Local Recurrence ◽  
Lymph Node Dissection ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Lower Rectal Cancer ◽  
Node Dissection ◽  
Lateral Lymph Node

Abstract Background: The impact of lateral lymph node dissection (LLND) in locally advanced lower rectal cancer remains controversial. This study is to compare total mesorectal excision (TME) with or without LLND in lower rectal cancer cases of stage II/III.Methods: The electronic databases were systematically searched that compared TME with or without LLND among patients with lower rectal cancer in clinical stage II/III. Subgroup analysis was performed considering neoadjuvant chemoradiotherapy (nCRT). The hazard ratios (HR), relative risk (RR), and weighted mean difference (WMD) were pooled.Results: Twelve studies of 4458 patients of this meta-analysis demonstrate, LLND alone significantly reduced the local recurrence rate of patients who did not receive nCRT (RR 0.71, P=0.004), while the difference was not significant when combined with nCRT (RR 0.70, P=0.36). The analysis shows TME with LLND was associated with significantly longer operation time (WMD 90.73 min, P<0.001), more intraoperative blood loss (WMD 303.20 mL, P<0.001), and postoperative complications (RR=1.35, P=0.02). Whereas Urinary dysfunction (RR 1.44, P=0.38), sexual dysfunction (RR 1.41, P=0.17), and postoperative mortality (RR=1.52, P=0.70), were similar between these two groups. Statistically, no significant differences were observed in OS (HR 0.93, P=0.62), DFS (HR 0.99, P=0.96), total recurrence (RR 0.98, P=0.83), lateral recurrence (RR 0.49, P=0.14), or distal recurrence (RR 0.95, P=0.78) between these two groups regardless of whether nCRT was performed or not.Conclusions: The study shows LLND alone decreases the local recurrence without using nCRT irrespective of the survival advantage in locally advanced lower rectal cancer. The benefit of controlling local recurrence by LLND alone makes us reconsider the usage of nCRT with LLND.Registration: The protocol for this meta-analysis was registered prospectively with PROSPERO (CRD42020135575) on May 16, 2019.

scholarly journals Lateral Lymph Node Dissection in Treatment for Advanced Lower Rectal Cancer.

2001 ◽  
Vol 34 (10) ◽  
pp. 1512-1521
Author(s):  
Yuji Nakafusa ◽  
Yoshimi Hirohashi ◽  
Toshiya Tanaka ◽  
Yoshihiko Kitajima ◽  
Seiji Sato ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Lateral Lymph Node Dissection ◽  
Lower Rectal Cancer ◽  
Node Dissection ◽  
Lateral Lymph Node

scholarly journals Exploratory analysis of lateral pelvic sentinel lymph node status for optimal management of laparoscopic lateral lymph node dissection in advanced lower rectal cancer without suspected lateral lymph node metastasis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Yasui ◽  
Masayuki Ohue ◽  
Shingo Noura ◽  
Norikatsu Miyoshi ◽  
Yusuke Takahashi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Lower Rectal Cancer ◽  
Rectal Cancer Surgery ◽  
Node Dissection ◽  
Lateral Lymph Node ◽  
Rectal Cancers ◽  
Lateral Pelvic Lymph Nodes

Abstract Background Total mesorectal excision (TME) and lateral lymph node dissection (LLND) without radiotherapy (RT) are standard treatment for lower cT3/4 rectal cancers in Eastern countries. In comparative studies, both TME + LLND and RT + TME yield good local control. Although Japanese guidelines recommend LLND for locally advanced rectal cancers below the peritoneal reflection, LLND dissection of clinically negative lateral pelvic lymph nodes (LPLN) is controversial, and laparoscopic TME + LLND is technically challenging and time-consuming. New optical instruments for laparoscopy allow easy perioperative sentinel lymph node (SLN) identification using ICG. The SLN concept may facilitate accurate diagnosis of LPLN involvement, and thus reduce LLND in laparoscopic rectal cancer surgery. Here we investigated lateral pelvic SLN navigation surgery for SLN detection during laparoscopic rectal cancer surgery. Methods This study included 21 patients with clinical StageII/III lower rectal cancer without LPLN enlargement, who underwent curative laparoscopic surgery. All patients underwent TME, followed by lateral SLN identification and biopsy using ICG, and then laparoscopic LLND. ICG fluorescence imaging was conducted using the laparoscopic near-infrared camera system. Results Lateral SLNs were successfully identified in 16 (76.2%) of the 21 patients. Among the 15 patients without SLN tumor metastasis, the dissected lateral non-SLNs were all negative. Conclusions A lack of metastasis in the lateral pelvic SLN seems to reflect a lack of metastases to all lateral LNs. Our present results suggest that this laparoscopic ICG-guided SLN strategy may be a low-risk and time-saving method to prevent laparoscopic LLND in cases with negative lateral pelvic lymph nodes.

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