The assessment of urinary function following extended lymph node dissection for colorectal cancer

Çöl, Cavit; Hasdemir, Oğuz; Yalçın, Erol; Güzel, Hatice; Tunç, Gündüz; Bilgen, Köksal; Küçükpınar, Tevfik

doi:10.1016/j.ejso.2004.11.008

Cited by 22 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seven studies [ 43 , 45 , 46 , 50 , 62 , 63 , 67 ], including 1718 patients (665 LLND and 1053 NLLND), reported urinary dysfunction. The incidence of urinary retention was significantly higher in the LLND patients (37%) if compared to the NLLND group (24.4%) (RR 1.88, 95% CI 1.11 to 3.19; I 2 = 68%) (Fig.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

Anania

Davies

Arezzo

et al. 2021

Int J Colorectal Dis

View full text Add to dashboard Cite

The role of lateral lymph node dissection (LLND) during total mesorectal excision (TME) for rectal cancer is still controversial. Many reviews were published on prophylactic LLND in rectal cancer surgery, some biased by heterogeneity of overall associated treatments. The aim of this systematic review and meta-analysis is to perform a timeline analysis of different treatments associated to prophylactic LLND vs no-LLND during TME for rectal cancer. Methods A literature search was performed in PubMed, SCOPUS and WOS for publications up to 1 September 2020. We considered RCTs and CCTs comparing oncologic and functional outcomes of TME with or without LLND in patients with rectal cancer. Results Thirty-four included articles and 29 studies enrolled 11,606 patients. No difference in 5-year local recurrence (in every subgroup analysis including preoperative neoadjuvant chemoradiotherapy), 5-year distant and overall recurrence, 5-year overall survival and 5-year disease-free survival was found between LLND group and non LLND group. The analysis of post-operative functional outcomes reported hindered quality of life (urinary, evacuatory and sexual dysfunction) in LLND patients when compared to non LLND. Conclusion Our publication does not demonstrate that TME with LLND has any oncological advantage when compared to TME alone, showing that with the advent of neoadjuvant therapy, the advantage of LLND is lost. In this review, the most important bias is the heterogeneous characteristics of patients, cancer staging, different neoadjuvant therapy, different radiotherapy techniques and fractionation used in different studies. Higher rate of functional post-operative complications does not support routinely use of LLND.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Urinary incontinence Four studies (62,63,65,67), including 341 patients (119 LLND and 222 NLLND), reported urinary incontinence. The incidence of urinary incontinence was similar between the LLND group (23.5%) and the NLLND group (27.4%) (RR 1.35, 95% CI 0.94 to 1.92; I 2 = 0%) (Fig.…”

Section: Urinary Retentionmentioning

confidence: 99%

Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

Anania

Davies

Arezzo

et al. 2021

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

“…Lateral pelvic sidewall lymphadenectomy has an adverse impact on the quality of life of patients, in terms of urinary [ 23 – 25 ] and sexual [ 21 , 26 , 27 ] function as previously demonstrated for primary rectal cancer, as the autonomic nerves in the region are at high risk or are sacrificed to achieve the optimum oncological outcome. Therefore, a significant amount of time is required preoperatively to discuss the benefits and risks of extended lymphadenectomy with patients due to undergoing surgery for primary cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

Extended lymphadenectomy for locally advanced and recurrent rectal cancer

Georgiou

Ali

Brown

et al. 2017

Int J Colorectal Dis

View full text Add to dashboard Cite

PurposeThe purpose of this study is to assess the value of extended (lateral) lymphadenectomy (EL) in the operative management of locally advanced and recurrent rectal cancer.MethodsPatients that underwent exenterative surgery for locally advanced or recurrent rectal cancer between 2006 and 2009 were included in the study. A decision for EL was taken at the local multidisciplinary meeting based on the radiological findings. Perioperative and oncological outcomes were assessed and compared between the EL and non-EL group prospectively.ResultsForty-one consecutive patients were included in the study (EL = 17). The median age was 57 (40–71) for EL and 66 (39–81) years for non-EL. Of patients, 27 (EL = 13) and 14 (EL = 4) underwent pelvic exenteration and abdominosacral resection, respectively. Twelve (EL = 7) patients were diagnosed with locally advanced primary rectal cancer. Thirty-one (EL = 12) patients received neoadjuvant radiotherapy. The median intraoperative time, blood loss and hospital stay were 9 h (3–13), 1.5 l (0.3–7) and 14 days (12–72), respectively, for the EL group, and 8 h (4–15), 1.6 l (0.25–17) and 14 days (10–86), respectively, for the non-EL (p ≥ 0.394). Morbidity was similar between the two groups (EL = 4, non-EL = 9; p = 0.344). Complete tumour resection (R0) was achieved in 30 (73.17%) patients, 12 (70.58%) in the EL group and 18 (75%) in the non-EL group (p = 0.649). There was no significant difference in 5-year survival (EL = 60.7%, non-EL = 75.2%; p = 0.447), local recurrence (EL = 53.6%, non-EL = 65.4%; p = 0.489) and disease-free survival (EL = 53.6%, non-EL = 51.4%; p = 0.814).ConclusionsThe present study demonstrated that EL does not provide a statistically significant advantage in survival or recurrence rates, for patients with locally advanced primary or recurrent rectal cancer.

show abstract

“…In early reports from Japan, LLND included an extended systematic lymphadenectomy, which means para-aortic and paracaval lymphatic dissection from the left renal vein to the aortic bifurcation along the adventitial layers of the inferior vena cave and abdominal aorta [ 24 ]. This procedure accompanied inevitable functional deteriorations [ 25 , 26 ] and increased incidences of urine-voiding failure (39.4% after the extended lymphadenectomy vs. 8.8% after the conventional lymphadenectomy) and sexual impotency (76% vs. 37.5%). In the meta-analysis, the extended lymphadenectomy showed a 3.7 times higher risk of urinary dysfunction and a 2.08 times higher risk of urinary retention [ 8 ].…”

Section: Functional Outcomes After a Lateral Lymph Node Dissectionmentioning

confidence: 99%

Lateral Lymph Node Dissection With the Focus on Indications, Functional Outcomes, and Minimally Invasive Surgery

Kim

2018

Ann Coloproctol

View full text Add to dashboard Cite

The lateral lymph node dissection (LLND) is still a subject of great debate as to the appropriate treatment for patients with mid to low advanced rectal cancer. The guidelines of the Japanese Society for Cancer of the Colon and Rectum recommend a LLND for patients with T3/4 rectal cancer below the peritoneal reflection. However, in most Western countries, a routine LLND is not recommended unless a node or nodes are clinically suspicious for metastasis. Even after preoperative chemoradiotherapy (CRT), an 8% to 12% lateral pelvic recurrence was noted. The size of the lateral lymph node and responsiveness to preoperative CRT should be the main factors for selecting appropriate patients to undergo a LLND. In addition, from the recent literature, a laparoscopic LLND is safe and oncologically feasible and might have some advantages in short-term outcomes.

show abstract

The assessment of urinary function following extended lymph node dissection for colorectal cancer

Cited by 22 publications

References 23 publications

Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

Extended lymphadenectomy for locally advanced and recurrent rectal cancer

Lateral Lymph Node Dissection With the Focus on Indications, Functional Outcomes, and Minimally Invasive Surgery

Contact Info

Product

Resources

About