Diagnosis and treatment of lateral lymph node metastasis in 4K laparoscopic surgery for middle and low rectal cancer
10.3760/cma.j.cn115610-20201110-00711
- VernacularTitle:4K腹腔镜中低位直肠癌侧方淋巴结转移诊断与综合治疗
- Author:
Ying YANG
1
;
Wenjian MENG
;
Ziqiang WANG
;
ZongGuang ZHOU
Author Information
1. 四川大学华西医院胃肠外科,成都 610041
- Keywords:
Rectal neoplasms;
Middle and low rectum;
4K resolution;
Lateral lymph node metastasis;
Neoadjuvant chemoradiotherapy;
Magnetic resonance imaging;
Laparoscop
- From:
Chinese Journal of Digestive Surgery
2021;20(S1):67-72
- CountryChina
- Language:Chinese
-
Abstract:
Lateral lymph node metastasis (LLNM) is one of the major causes for post-operative local recurrence of middle and low rectal cancer. At present, there are still controversies on the diagnosis and treatment of LLNM. The radiological assessment of LLNM generally relies on morphological criteria such as the size or shape of the node or the response to therapy, in which the diagnostic accuracy of MRI is superior to that of other imaging techniques. Neoadjuvant chemoradiotherapy could not achieve good local control for suspicious LLNM. Lateral lymph node dissection (LLND) can reduce tumor local recurrence significantly, but the clinical value of LLND in survival and quality of life of patients has been questioned. 4K laparoscope can decrease the incidence of perioperative complications and urinary and sexual dysfunction to a certain extent. Thus, selective LLND should be undertaken to patients with suspicious LLNM after neoadjuvant chemoradiotherapy, in order to reduce tumor local recurrence and improve the prognosis of patients. The authors elaborate on diagnosis and treatment including surgery or chemoradiotherapy of LLNM in 4K laparoscopic surgery for middle and low rectal cancer combined with their own experiences.
