Ann Coloproctol.  2018 Oct;34(5):229-233. 10.3393/ac.2018.10.26.

Lateral Lymph Node Dissection With the Focus on Indications, Functional Outcomes, and Minimally Invasive Surgery

• Kim MJ
• Oh JH

• KMID: 2427529
• DOI: http://doi.org/10.3393/ac.2018.10.26

Abstract

The lateral lymph node dissection (LLND) is still a subject of great debate as to the appropriate treatment for patients with mid to low advanced rectal cancer. The guidelines of the Japanese Society for Cancer of the Colon and Rectum recommend a LLND for patients with T3/4 rectal cancer below the peritoneal reflection. However, in most Western countries, a routine LLND is not recommended unless a node or nodes are clinically suspicious for metastasis. Even after preoperative chemoradiotherapy (CRT), an 8% to 12% lateral pelvic recurrence was noted. The size of the lateral lymph node and responsiveness to preoperative CRT should be the main factors for selecting appropriate patients to undergo a LLND. In addition, from the recent literature, a laparoscopic LLND is safe and oncologically feasible and might have some advantages in short-term outcomes.

Keyword

Rectal neoplasms; Lymph Nodes; Chemoradiotherapy

MeSH Terms

Asian Continental Ancestry Group
Chemoradiotherapy
Colonic Neoplasms
Humans
Lymph Node Excision*
Lymph Nodes*
Minimally Invasive Surgical Procedures*
Neoplasm Metastasis
Rectal Neoplasms
Rectum
Recurrence