Preliminary experience with lateral pelvic lymph node dissection in locally advanced rectal cancer

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
Snita SinukumarAvanish P Saklani

Abstract

In 15 % to 25 % of patients, the lateral pelvic lymph nodes (LPN) are known to be involved especially with rectal tumors lying below the peritoneal reflection. While total mesorectal excision (TME) ensures removal of locoregional lymph nodes, it does not address the LPN. Lateral pelvic lymph node dissection (LPND) is being performed in selected scenarios for persistent LPN after administration of neoadjuvant chemoradiotherapy (NACTRT). Through our study, we share our initial experience with LPND in patients with persistent pelvic nodes after NACTRT in advanced rectal cancers. From October 2013 to November 2014, eight patients underwent TME with LPND after NACTRT. LPND was performed when pelvic node metastasis was suspected on preoperative magnetic resonance imaging (MRI) and persisted following preoperative NACTRT. Clinicopathological and perioperative details were recorded for these eight patients. Out of the 144 patients operated with curative intent for rectal LARC, eight (5 %) patients had persistent lateral pelvic nodes following NACTRT. These patients underwent a TME with LPND. The median operative time was 240 min, and the median blood loss was 800 mL. Two out of eight patients showed residual disease in the lateral pelv...Continue Reading

References

Dec 4, 2003·The British Journal of Surgery·S FujitaY Moriya
Oct 17, 2006·Diseases of the Colon and Rectum·Kenichi SugiharaTetsuichiro Muto
Sep 22, 2009·The Lancet Oncology·Panagiotis GeorgiouParis Tekkis
May 3, 2012·Annals of Surgery·Takashi AkiyoshiUNKNOWN Japanese Society for Cancer of the Colon and Rectum
Apr 25, 2014·Annals of Surgical Treatment and Research·Sung Uk BaeNam Kyu Kim

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Citations

Sep 9, 2016·South Asian Journal of Cancer·Nikhil Suresh GhadyalpatilSaklani Avanish
Aug 31, 2019·World Journal of Surgery·Y AtefJ B Tuynman
Dec 8, 2020·Indian Journal of Surgical Oncology·Jitender RohilaAvanish Saklani

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