A Leggeri1, M Roseano, A Balani, A Turoldo. 1. Universita' degli Studi di Trieste, Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Italy.
Abstract
PURPOSE: The aim of this study was to evaluate the roles of the lymphadenectomy in the surgical treatment of rectal cancer. METHODS: On the basis of our experience of 252 curative operations for rectal cancer, we analyze survival and recurrence in relation to the lymph node involvement and to the level of the lymph nodes where the metastases are located. All patients underwent a lymphadenectomy with high ligation of the inferior mesenteric artery and removal of the lumboaortic lymph nodes from the left renal vein to the aortic bifurcation. Pelvic lymphadenectomy was performed in 16 cases. RESULTS: Five-year survival was 70.6 percent in patients with no lymph node involvement, 68.2 percent in patients with pararectal lymph nodes N+, 25 percent in patients with involvement of intermediate lymph nodes, and 30 percent in patients with involvement of lumboaortic lymph nodes. In no case was there involvement of the hypogastric lymph nodes. On the basis of our experience and from results in the literature, we consider an upward extended lymphadenectomy with high ligation of the inferior mesenteric artery is warranted since it enables the tumor to be staged accurately and may lead to survival even in cases of advanced lymph node involvement.
PURPOSE: The aim of this study was to evaluate the roles of the lymphadenectomy in the surgical treatment of rectal cancer. METHODS: On the basis of our experience of 252 curative operations for rectal cancer, we analyze survival and recurrence in relation to the lymph node involvement and to the level of the lymph nodes where the metastases are located. All patients underwent a lymphadenectomy with high ligation of the inferior mesenteric artery and removal of the lumboaortic lymph nodes from the left renal vein to the aortic bifurcation. Pelvic lymphadenectomy was performed in 16 cases. RESULTS: Five-year survival was 70.6 percent in patients with no lymph node involvement, 68.2 percent in patients with pararectal lymph nodes N+, 25 percent in patients with involvement of intermediate lymph nodes, and 30 percent in patients with involvement of lumboaortic lymph nodes. In no case was there involvement of the hypogastric lymph nodes. On the basis of our experience and from results in the literature, we consider an upward extended lymphadenectomy with high ligation of the inferior mesenteric artery is warranted since it enables the tumor to be staged accurately and may lead to survival even in cases of advanced lymph node involvement.
Authors: Jae Young Kwak; Jae Seung Kim; Hye Jin Kim; Hyun Kwon Ha; Chang Sik Yu; Jin Cheon Kim Journal: World J Surg Date: 2012-08 Impact factor: 3.352
Authors: A Alici; M Kement; C Gezen; T Akin; S Vural; N Okkabaz; E Basturk; A Yegenoglu; M Oncel Journal: Tech Coloproctol Date: 2010-03 Impact factor: 3.781