Published consecutively in the Official Journal of the American Society of Colon and Rectal Surgeons and the International Journal Biomedicine
The research team led by Professors Lee Yoon-seok and Bae Jeong-hoon from the Department of Colorectal Surgery at Catholic University Seoul St. Mary's Hospital published two consecutive papers on lateral pelvic lymph node dissection in rectal cancer in international academic journals.
Looking at the anatomical structure around the rectum, the rectum is located within the narrow pelvic cavity and is surrounded by the mesorectum. On the sides of the rectum and mesorectum are the lateral pelvis spaces on the right and left sides of the pelvic cavity. In front, there are the seminal vesicles and prostate in males, and the uterus and posterior vaginal wall in females. Behind, there is the sacrum, the lowest part of the spine.
In rectal cancer surgery, total mesorectal excision, which involves removing both the rectum and mesorectum, is known as the standard surgical method. In addition to this total mesorectal excision, there is a surgical method that additionally performs lymph node dissection of the lateral pelvis, but the necessity of this surgery has been controversial for various reasons.
The research team analyzed patients diagnosed with rectal cancer at three affiliated hospitals of Catholic Medical College (Seoul St. Mary's Hospital, Incheon St. Mary's Hospital, and St. Vincent's Hospital) who underwent lateral pelvic lymph node dissection in addition to total mesorectal excision. As a result, when rectal cancer was located within 5 cm from the outer edge of the anus, lateral pelvic lymph nodes enlarged to 6 mm or more, and when located more than 5 cm from the outer edge of the anus, lateral pelvic lymph nodes enlarged to 8 mm or more, lateral pelvic lymph node dissection showed 100% sensitivity (100% detection when cancer cells were present), proposing this as a new surgical criterion. This study was published in 'Diseases of the Colon & Rectum,' the official journal of the American Society of Colon and Rectal Surgeons.
The same patients were analyzed to compare robotic surgery and laparoscopic surgery, and it was reported in the international journal 'Biomedicine' that robotic lateral pelvic lymph node dissection could harvest more lateral pelvic lymph nodes than laparoscopic surgery, with no differences in complications or survival rates, indicating safety.
Professor Lee Yoon-seok said, "Many clinicians still consider this surgery difficult and risky, but according to this research, it is expected to contribute to the popularization and standardization of robotic lateral pelvic lymph node dissection in the future." Professor Bae Jeong-hoon stated, "This is the first study to reveal that the location of rectal cancer should be considered when setting criteria for lateral pelvic lymph node dissection," adding, "Based on this, we will conduct multicenter research with hospitals under the Catholic Medical Center as well as domestic and international medical institutions to standardize the criteria for lateral pelvic lymph node dissection."
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