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

Annals of Coloproctology 2018년 34권 5호 p.229 ~ 233
김민중, 오재환,
소속 상세정보
김민중 ( Kim Min-Jung ) - Seoul National University College of Medicine Department of Surgery
오재환 ( Oh Jae-Hwan ) - National Cancer Center Research Institute and Hospital Center for Colorectal Cancer

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.

키워드

Rectal neoplasms; Lymph Nodes; Chemoradiotherapy

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