Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer

Aloysius MN Tan; Kar Yong Wong

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Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer

Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer

作者：

Aloysius MN Tan Kar Yong Wong

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LATERAL

PELVIC

LYMPH

node

dissection

Robotic

RECTAL

surgery

LOCALLY

advanced

RECTAL

cancer

Local

RECURRENCE

PELVIC

side

wall

RECURRENCE

摘要：

BACKGROUND Pelvic recurrence after rectal cancer surgery is still a significant problem despite the introduction of total mesorectal excision and chemoradiation treatment(CRT),and one of the most common areas of recurrence is in the lateral pelvic lymph nodes.Hence,there is a possible role for lateral pelvic lymph node dissection(LPND)in rectal cancer.AIM To evaluate the short-term outcomes of patients who underwent minimally invasive LPND during rectal cancer surgery.Secondary outcomes were to evaluate for any predictive factors to determine lymph node metastases based on pre-operative scans.METHODS From October 2016 to November 2019,22 patients with stage II or III rectal cancer underwent minimally invasive rectal cancer surgery and LPND.These patients were all discussed at a multidisciplinary tumor board meeting and most of them received neoadjuvant chemoradiation prior to surgery.All patients had radiologically positive lateral pelvic lymph nodes on the initial staging scans,defined as lymph nodes larger than 7 mm in long axis measurement,or abnormal radiological morphology.LPND was only performed on the involved side.RESULTS Majority of the patients were male(18/22,81.8%),with a median age of 65 years(44-81).Eighteen patients completed neoadjuvant CRT pre-operatively.18 patients(81.8%)had unilateral LPND,with the others receiving bilateral surgery.The median number of lateral pelvic lymph nodes harvested was 10(3-22)per pelvic side wall.8 patients(36.4%)had positive metastases identified in the lymph nodes harvested.The median pre-CRT size of these positive lymph nodes was 10 mm.Median length of stay was 7.5 d(3-76),and only 2 patients failed initial removal of their urinary catheter.Complication rates were low,with only 1 lymphocele and 1 anastomotic leak.There was only 1 mortality(4.5%).There have been no recurrences so far.CONCLUSION Chemoradiation is inadequate in completely eradicating lateral wall metastasis and there are still technical limitations in accurately diagnosing metastases in these areas.A

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篇名	Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer
来源期刊	世界胃肠外科杂志:英文版(电子版)	学科	医学
关键词	LATERAL PELVIC LYMPH node dissection Robotic RECTAL surgery LOCALLY advanced RECTAL cancer Local RECURRENCE PELVIC side wall RECURRENCE
年，卷（期）	2020,（4）	所属期刊栏目
研究方向		页码范围	178-189
页数	12页	分类号	R735.37
字数		语种
DOI