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Multicenter Study
. 2022 May 2;6(3):zrac068.
doi: 10.1093/bjsopen/zrac068.

Laparoscopic versus open lateral pelvic lymph node dissection in locally advanced rectal cancer: multicentre retrospective cohort study

Han-Ki Lim  1   2 , Minjung Kim  1   2   3 , Ji Won Park  1   2   3 , Seung-Bum Ryoo  1   2 , Kyu Joo Park  1   2 , Heung-Kwon Oh  1   4 , Duck-Woo Kim  1   4 , Sung-Bum Kang  1   4 , Dong Woon Lee  5 , Sung Chan Park  5 , Jae Hwan Oh  5 , Seung-Yong Jeong  1   2   3 ; Seoul Colorectal Research Group (SECOG)
Collaborators, Affiliations
Multicenter Study

Laparoscopic versus open lateral pelvic lymph node dissection in locally advanced rectal cancer: multicentre retrospective cohort study

Han-Ki Lim et al. BJS Open. .

Abstract

Background: Lateral pelvic lymph node dissection (LPLND) is an option in the treatment of rectal cancer and may reduce local recurrence/improve disease-free survival. Advancements in minimally invasive technology have improved the ability to identify anatomy and neurovascular structures that may help in LPLND. The aim of this retrospective study was to evaluate the technical feasibility and oncological safety of laparoscopic LPLND compared with the open LPLND.

Method: Between July 2010 and July 2019, patients from three tertiary referral hospitals who underwent LPLND with total mesorectal excision for primary rectal cancer were included. Baseline patient characteristics, perioperative outcomes, pathologic results, recurrence, and survival were compared between the laparoscopic and open groups.

Results: There were 126 and 70 patients in the laparoscopic and open groups respectively. The laparoscopic group had less estimated blood loss (100 ml versus 300 ml, P < 0.001) and lower transfusion rate (0.8 per cent versus 10.0 per cent; P = 0.003) but longer operating times (318 min versus 270 min, P = 0.004). The laparoscopic group had fewer wound infections (1.6 per cent versus 10.0 per cent, P = 0.011) and neuropathy (0 per cent versus 4.3 per cent, P = 0.044). Lateral pelvic recurrence rate was 7.6 per cent in the laparoscopic group and 19.6 per cent in the open group (P = 0.053). Recurrence-free survival (72.2 per cent versus 63.5 per cent; P = 0.190) and overall survival (93.3 per cent versus 85.0 per cent; P = 0.118) were not significantly different.

Conclusion: Laparoscopic LPLND was associated with improved perioperative outcomes and non-inferior oncological outcomes.

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Figures

Fig. 1
Fig. 1
Flow chart of the study population
Fig. 2
Fig. 2
Kaplan–Meier curves of lateral pelvic recurrence rate, recurrence-free survival, and overall survival according to surgical approach
See this image and copyright information in PMC

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