Lower rectal lymphatic drainage and necessity of lateral lymph node dissection for low rectal cancer / 中国实用外科杂志

ABSTRACT

There are three lymphatic drainage pathways in lower rectal cancer,including upper,lower and lateral lymphatic drainage pathway. Lateral metastasis of rectal cancer caused by lateral lymphatic drainage pathway is an important cause of pelvic recurrence. Evidence-based medical evidence shows that preoperative concurrent chemoradiotherapy and radiotherapy can not completely kill the lymph node metastasis to the lateral side,and the positive residual rate is more than 60%. For cases with lateral lymph node metastasis after preoperative concurrent chemoradiotherapy,surgical removal of metastatic lymph nodes is the most important treatment,even the only way for patients to achieve long-term survival. Strictly grasping the indications of lateral clearance surgery to improve the positive coincidence rate of pathology,and implementing standard clearance to reduce the incidence of surgical complications through precise operation are expected to bring double benefits of local control and prolonged survival to patients with lateral metastasis of rectal cancer.