The Application Research Of Lateral Lymph Node Dissection On The Mid-low Rectal Cancer Operation

Rectal cancer is one of the most common malignancies in the world and aleading cause of cancer deaths with an increasing incidence in more recent years.Lymph node metastasis is the most common form of spread in rectal cancer,and is themain influence factors for5years survival rate and local recurrence of patients. Sofar，an effective method to improve the cure rate of rectal cancer is lymph nodedissection. Rational lymph node dissection is of great significance for the prognosis ofthe patients. As technology advances, growing understand about the lymphaticdrainage of the rectum, lateral lymph node metastasis is paid attention to gradually inmid-low rectal cancer. Confirmed after extensive research, the main direction oflymph node metastasis of peritoneal reflection below mid-low rectal cancer is laterallymph nodes, but the focus of domestic and foreign dispute is the effect of laterallymph node dissection on the survival rate and recurrence rate. The Japanese scholarsagree that lateral lymph node dissection has great significance in mid-low rectalcancer operation, but most European and American scholars deny lateral lymph nodedissection, that lateral lymph node dissection is not much significance to the prognosisof patients. At present in China, the main advocate of rectal cancer operation isfunctional extended radical resection(FERR), also called autonomic nervepreservation extended radical resection of rectal carcinoma: the maximum resection ofprimary tumor、rational lymph node dissection、total mesorectal excision(TME) andtry to keep autonomic nerve.Objective: To research the application value of lateral lymph node dissection inmid-low rectal cancer.Methods: Retrospcetive research bout287mid-low rectal cancer cases during2006 January to2010December,divided into two groups: total mesorectal excision (TME)(control group) and TME+lateral lymph node dissection operation (test group).According to the Duck ’ tumor s stage, TNM stage and other clinicopathologicalfactors for classification, analysis of prognosis between the two groups,and researchthe application value of lateral lymph node dissection in rectal cancer.Results: There is no significant difference in the distribution of cases according todifferent TNM classification and histological type between two groups. According toTNM and histopathological classification, lateral lymph node metastasis rate turns outto be higher with more invasive TNM classification and more malignanthistopathological type. The total recurrence of the test group is5.1%,and the controlgroup is15.8%, the difference of two groups was statistically significant (P<0.05).Conclusions: lateral lymph node metastasis rate was positively correlated with thedegree of histological malignancy and invasion depth of the tumor, lateral lymph nodedissection can effectively reduce the rate of local recurrence and distant metastasis,improve the survival rate and quality of life of patients after operation,has positivesignificance.