Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection

作者：Yoshihiro Moriya, Keiichi Hojo, Toshio Sawada, Yasuo Koyama · 发表于：Diseases of the Colon & Rectum · 年份：1989 · DOI：10.1007/bf02553486 · 被引用次数：284 · 研究领域：Colorectal Cancer Surgical Treatments、Colorectal and Anal Carcinomas、Gastric Cancer Management and Outcomes

Two hundred thirty two patients with rectal cancer at or below the peritoneal reflection, who underwent extended systematic lymphadenectomy, especially lateral node dissection, were reviewed with respect to survival rate, degree of surgical technique, and mode of recurrence. On the basis of the extent of lateral node spread, two types of lateral node dissection were performed, consisting of preservation of internal iliac vessels (conventional) and en bloc excision of these vessels (extended). The overall disease-free five-year survival rate was 69.4 percent in all patients--75.8 percent for those who underwent extended resection and 67.4 percent for those who underwent conventional resection an excellent survival rate of 49 percent of patients with lateral node metastasis was obtained. The analysis was carried out with regard to prognostic factors such as number of node metastases, obesity index, mode of recurrence, etc. We would recommend that systemic lymphadenectomy with lateral node dissection be performed for advanced rectal cancer at or below the peritoneal reflection.