Effect on the Local Recurrence and the Survival of Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection in Rectal Cancer.
10.3393/jksc.2007.23.1.46
- Author:
Byung Gwan CHOI
1
;
Hyung Soo KIM
;
Kyeong Won SEO
;
Jae Kyoon JU
;
Seong Yeob RYU
;
Young Kyu PARK
;
Hyeong Rok KIM
;
Dong Yi KIM
;
Young Jin KIM
Author Information
1. Division of Gastrointestinal Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. pping77@naver.com
- Publication Type:Original Article
- Keywords:
Rectal cancer;
Total mesorectal excision;
Lateral pelvic lymph node dissection;
Recurrence
- MeSH:
Humans;
Ligation;
Lymph Node Excision*;
Lymph Nodes*;
Neoplasm Metastasis;
Pelvis;
Quality of Life;
Rectal Neoplasms*;
Recurrence*;
Retrospective Studies;
Survival Rate
- From:Journal of the Korean Society of Coloproctology
2007;23(1):46-52
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: One of the most common sites of recurrence after a curative resection of rectal cancer is the pelvis, and local control is a major goal of surgical treatment. The advantages of lateral pelvic lymph node dissection are regarded as questionable because lateral pelvic lymph node metastasis does not occur so frequently and because a lateral lymphadenectomy has a negative influence on the postoperative quality of life. The aim of this study was to clarify if lateral pelvic lymph node dissection (LPLD) conferred any benefit. METHODS: A total of 769 patients who underwent curative surgery for rectal cancer between 1981 and 2005 at the Department of Surgery, OOO Hospital, were reviewed retrospectively. One hundred ninety-three of these patients underwent a lateral pelvic lymph node dissection, and 576 patients had a total mesorectal excision with high ligation of the IMA. RESULTS: There was no difference in pathological characteristics between the two groups. Patients who underwent a lateral pelvic lymph node dissection had no statistically significant difference in terms of the 5-year survival rate at stage II and III (64% vs 65% at stage II, P=0.391; 49% vs 47% at stage III, P=0.815). CONCLUSIONS: A lateral pelvic lymph node dissection has no advantage as part of a standard operation for rectal cancer. A total mesorectal excision alone has good local control and survival compared with a lateral pelvic lymph node dissection.
