Purpose: Lateral pelvic node dissection (LPLND) is indicated in the surgical management of clinically significant pelvic lymphadenopathy associated with rectal malignancies. However, procedure-related morbidity, including the incidence and predisposing factors for lymphoceles arising in this setting have not been adequately evaluated.
Methods: This retrospective single-institution study included 183 patients with nonmetastatic, lateral node-positive rectal cancer undergoing total mesorectal excision with LPLND between June 2014 and May 2023 to determine the incidence and severity of postoperative complications using the Clavien-Dindo system, with logistic regression performed to model a relationship between lymphocele-development and potentially-predictive variables.
Results: In this cohort, mean age was 45.3 ± 12.81 years, 62.8% were male, and 27.9% had body mass index ≥ 25 kg/m. Median tumor-distance from the verge was 3.0 (interquartile range [IQR] 1.0-5.0) cm. Following radiotherapy in 86.9%, all patients underwent surgery: 30.1% had open resection and 26.2% had bilateral LPLND. Median nodal-yield was 6 (IQR 4-8) per side. Postoperatively, 45.3% developed complications, with 18% considered clinically significant. Lymphoceles, detected in 21.3%, comprised the single-most common sequelae following LPLND, 46.2% arising within 30 days of surgery and 33.3% requiring intervention. On multivariate analyses, obesity (hazard ratio [HR] 2.496; 95% confidence interval [CI] 1.094-5.695), receipt of preoperative radiation (HR 10.026; 95% CI 1.225-82.027), open surgical approach (HR 2.779; 95% CI 1.202-6.425), and number of harvested nodes (HR 1.105; 95% CI 1.026-1.190) were significantly associated with lymphocele-development.
Conclusions: Pelvic lymphoceles and its attendant complications represent the most commonly encountered morbidity following LPLND for rectal cancer, with obesity, neoadjuvant radiotherapy, open surgery, and higher nodal-yield predisposing to their development.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1245/s10434-024-16320-7 | DOI Listing |
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659379 | PMC |
Publication Analysis
Top Keywords
Similar Publications
Infrared thermal modulation endoscopy for label-free tumor detection.
Sci Rep
December 2024
Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, South Korea.
In optical imaging of solid tumors, signal contrasts derived from inherent tissue temperature differences have been employed to distinguish tumor masses from surrounding tissue. Moreover, with the advancement of active infrared imaging, dynamic thermal characteristics in response to exogenous thermal modulation (heating and cooling) have been proposed as novel measures of tumor assessment. Contrast factors such as the average rate of temperature changes and thermal recovery time constants have been investigated through an active thermal modulation imaging approach, yielding promising tumor characterization results in a xenograft mouse model.
View Article and Find Full Text PDFsurgery for rectal cancer often presents multiple tactical and technical challenges due to factors such as the tumor's extent, limited anatomical space, proximity to the anal sphincter complex, and the use of neoadjuvant radiotherapy. These factors can significantly increase the complexity of surgery and the risk of both immediate and delayed complications, which can occur intraoperatively or postoperatively. Objective: the aim of this study was to retrospectively analyze the causes, diagnostic methods, and management of complications in patients who underwent surgery for rectal cancer.
View Article and Find Full Text PDFcolorectal cancer is a common and serious condition, with surgical resection being the primary treatment for localized cases. Anastomotic dehiscence (AD) remains a significant postoperative complication, and anastomoses are typically created using either manual suturing or mechanical stapling, each with specific benefits and challenge. Material and this retrospective study analyzed outcomes in 100 rectal cancer patients who underwent surgical resection, with anastomoses performed via manual suturing (n=50) or mechanical stapling (n=50).
View Article and Find Full Text PDFSurgical navigation for targeted retroperitoneal lymph-node removal: a randomised, controlled, phase 3 trial.
EClinicalMedicine
August 2024
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Background: Metastatic retroperitoneal lymph node dissection (LND) for nodal recurrence is applied for a variety of cancers, such as urological, gynaecological and rectal cancer. Precise localisation and resection of these lymph nodes (LNs) during surgery can be challenging, especially after previous radiotherapy or surgery. The objective of this study was to assess the added value of surgical navigation for targeted LND in the retroperitoneum.
View Article and Find Full Text PDFPrediction model construction for the occurrence of LARS after neoadjuvant therapy combined with laparoscopic total mesorectal excision in male patients with mid-low rectal cancer.
Front Oncol
December 2024
Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China.
Background: Neoadjuvant chemoradiotherapy for rectal cancer improves surgical outcomes and reduces recurrence but can cause low anterior resection syndrome (LARS), affecting quality of life. This study aims to predict the risk of LARS in male patients with mid-low rectal cancer after laparoscopic total mesorectal excision (TME).
Methods: Clinical data from 203 male patients with mid-low rectal cancer who underwent neoadjuvant therapy and laparoscopic resection were collected.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!