Abstract
The goals of surgery for rectal cancer are to achieve curative resection and maintain quality of life while minimizing the risk of local recurrence and prolonging patient survival. The standard treatment for locally advanced rectal cancer in Japan is TME with lateral lymph node dissection (LLD). Lateral lymph node metastasis was present in 15.6–20.4% of patients with lower rectal cancer and that the risk of pelvic recurrence would decrease by 50% and the 5-year survival rate would improve by 8% when LLD was performed for T3 or T4 lower rectal cancer. The JCOG0212 trial, which is multicenter randomized controlled trial comparing mesorectal excision (ME) with or without LLD, reported that local recurrence was lower in the mesorectal excision (ME) with LLD group (7.4%) compared with the ME-only group (12.6%). The urinary complications and sexual dysfunction rates did not differ between the two groups.
We will describe the surgical procedures needed to perform nerve-sparing LLD in detail. Provided nerve-sparing LLD is performed accurately, local control of rectal cancer is excellent and does not cause urogenital dysfunction. We conclude the procedure appears to be safe and effective.
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Kagawa, H., Kinugasa, Y. (2018). Pelvic Autonomic Nerve Preservation and Lateral Pelvic Lymph Node Dissection: Techniques and Oncologic Benefits. In: Kim, N., Sugihara, K., Liang, JT. (eds) Surgical Treatment of Colorectal Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-5143-2_13
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DOI: https://doi.org/10.1007/978-981-10-5143-2_13
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