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The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study

INTRODUCTION: Laparoscopic lateral lymph node dissection (LLND) is an important treatment for patients with lateral lymph node metastasis. AIM: To assess the technical feasibility and investigate the surgical outcomes after LLND using the fascia space priority approach for patients with advanced mid...

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Autores principales: Sun, Yi, Lian, Lei, Zhang, Hong, Bai, Xuefeng, Xie, Zhongshi, Ouyang, Jun, Wang, Kai, Yuan, Hang, Xu, Chang, Luo, Henggui, Deng, Haijun, Li, Jun, Yang, Hongjie, Zhang, Zhichun, Li, Peng, Zhang, Xipeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193747/
https://www.ncbi.nlm.nih.gov/pubmed/34136026
http://dx.doi.org/10.5114/wiitm.2021.105143
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author Sun, Yi
Lian, Lei
Zhang, Hong
Bai, Xuefeng
Xie, Zhongshi
Ouyang, Jun
Wang, Kai
Yuan, Hang
Xu, Chang
Luo, Henggui
Deng, Haijun
Li, Jun
Yang, Hongjie
Zhang, Zhichun
Li, Peng
Zhang, Xipeng
author_facet Sun, Yi
Lian, Lei
Zhang, Hong
Bai, Xuefeng
Xie, Zhongshi
Ouyang, Jun
Wang, Kai
Yuan, Hang
Xu, Chang
Luo, Henggui
Deng, Haijun
Li, Jun
Yang, Hongjie
Zhang, Zhichun
Li, Peng
Zhang, Xipeng
author_sort Sun, Yi
collection PubMed
description INTRODUCTION: Laparoscopic lateral lymph node dissection (LLND) is an important treatment for patients with lateral lymph node metastasis. AIM: To assess the technical feasibility and investigate the surgical outcomes after LLND using the fascia space priority approach for patients with advanced middle and low rectal cancer. MATERIAL AND METHODS: Consecutive patients undergoing laparoscopic LLND using the fascia space priority approach from June 2017 to June 2020 were identified from 12 medical centres in mainland China. Three anatomic fascia spaces were dissected to establish the boundaries of the LLND, and the obturator and internal iliac lymph nodes were excised in an en bloc manner. Retrospective clinical data including patient characteristics, surgical details, and pathology were analysed. RESULTS: A total of 112 patients were identified. All surgeries were completed laparoscopically with no conversions. The mean operation time was 343.6 ±103.8 min for the entire procedure. The median blood loss was 100 ml (range: 100–700 ml). The median lymph node yield was 6 (range: 1–41), and lymph nodes were positive in 39.3% (44/112) of the patients. Sixteen (14.3%) patients had Clavien-Dindo I–II complications, no Clavien-Dindo III–IV complications were identified. The incidence of complications between the bilateral dissection group and the unilateral dissection group was not statistically different (p = 0.19). The complication rate between the “nCRT” group and the “no nCRT” group was not significantly different (p = 0.62) either. There were no perioperative deaths. CONCLUSIONS: Laparoscopic LLND using the fascia space priority approach is feasible and safe for patients with lateral lymph node metastasis.
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spelling pubmed-81937472021-06-15 The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study Sun, Yi Lian, Lei Zhang, Hong Bai, Xuefeng Xie, Zhongshi Ouyang, Jun Wang, Kai Yuan, Hang Xu, Chang Luo, Henggui Deng, Haijun Li, Jun Yang, Hongjie Zhang, Zhichun Li, Peng Zhang, Xipeng Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Laparoscopic lateral lymph node dissection (LLND) is an important treatment for patients with lateral lymph node metastasis. AIM: To assess the technical feasibility and investigate the surgical outcomes after LLND using the fascia space priority approach for patients with advanced middle and low rectal cancer. MATERIAL AND METHODS: Consecutive patients undergoing laparoscopic LLND using the fascia space priority approach from June 2017 to June 2020 were identified from 12 medical centres in mainland China. Three anatomic fascia spaces were dissected to establish the boundaries of the LLND, and the obturator and internal iliac lymph nodes were excised in an en bloc manner. Retrospective clinical data including patient characteristics, surgical details, and pathology were analysed. RESULTS: A total of 112 patients were identified. All surgeries were completed laparoscopically with no conversions. The mean operation time was 343.6 ±103.8 min for the entire procedure. The median blood loss was 100 ml (range: 100–700 ml). The median lymph node yield was 6 (range: 1–41), and lymph nodes were positive in 39.3% (44/112) of the patients. Sixteen (14.3%) patients had Clavien-Dindo I–II complications, no Clavien-Dindo III–IV complications were identified. The incidence of complications between the bilateral dissection group and the unilateral dissection group was not statistically different (p = 0.19). The complication rate between the “nCRT” group and the “no nCRT” group was not significantly different (p = 0.62) either. There were no perioperative deaths. CONCLUSIONS: Laparoscopic LLND using the fascia space priority approach is feasible and safe for patients with lateral lymph node metastasis. Termedia Publishing House 2021-04-09 2021-06 /pmc/articles/PMC8193747/ /pubmed/34136026 http://dx.doi.org/10.5114/wiitm.2021.105143 Text en Copyright: © 2021 Fundacja Videochirurgii https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Sun, Yi
Lian, Lei
Zhang, Hong
Bai, Xuefeng
Xie, Zhongshi
Ouyang, Jun
Wang, Kai
Yuan, Hang
Xu, Chang
Luo, Henggui
Deng, Haijun
Li, Jun
Yang, Hongjie
Zhang, Zhichun
Li, Peng
Zhang, Xipeng
The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
title The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
title_full The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
title_fullStr The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
title_full_unstemmed The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
title_short The feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
title_sort feasibility and technical strategy of a fascia space priority approach in laparoscopic lateral lymph node dissection for advanced middle and low rectal cancer: a retrospective multicentre study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193747/
https://www.ncbi.nlm.nih.gov/pubmed/34136026
http://dx.doi.org/10.5114/wiitm.2021.105143
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