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Surgery Today
Published in: Surgery Today 3/2020

Open Access 01-03-2020 | Rectal Cancer | Review Article

Laparoscopic and robotic lateral lymph node dissection for rectal cancer

Authors: Ryota Nakanishi, Tomohiro Yamaguchi, Takashi Akiyoshi, Toshiya Nagasaki, Satoshi Nagayama, Toshiki Mukai, Masashi Ueno, Yosuke Fukunaga, Tsuyoshi Konishi

Published in: Surgery Today | Issue 3/2020

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Abstract

In the era of neoadjuvant chemoradiotherapy/radiotherapy and total mesorectal excision, overall oncological outcomes after curative resection of rectal cancer are excellent, with local recurrence rates as low as 5–10%. However, lateral nodal disease is a major cause of local recurrence after neoadjuvant chemoradiotherapy/radiotherapy and total mesorectal excision. Patients with lateral nodal disease have a local recurrence rate of up to 30%. The oncological benefits of lateral pelvic lymph node dissection (LPLND) in reducing local recurrence, particularly in the lateral compartment, have been demonstrated. Although LPLND is not standard in Western countries, technical improvements in minimally invasive surgery have resulted in rapid technical standardization of this complicated procedure. The feasibility and short- and long-term outcomes of laparoscopic and robotic LPLND have been reported widely. A minimally invasive approach has the advantages of less bleeding and providing a better surgical view of the deep pelvic anatomy than an open approach. With precise autonomic nerve preservation, postoperative genitourinary dysfunction has been reported to be minimal. We review recent evidence on the management of lateral nodal disease in rectal cancer and technical improvements of LPLND, focusing on laparoscopic and robotic LPLND.
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Metadata
Title
Laparoscopic and robotic lateral lymph node dissection for rectal cancer
Authors
Ryota Nakanishi
Tomohiro Yamaguchi
Takashi Akiyoshi
Toshiya Nagasaki
Satoshi Nagayama
Toshiki Mukai
Masashi Ueno
Yosuke Fukunaga
Tsuyoshi Konishi
Publication date
01-03-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 3/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-020-01958-z

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