Impact of Lateral Pelvic Lymph Node Dissection on Evacuatory and Urinary Functions Following Low Anterior Resection for Advanced Rectal Carcinoma

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2005 Sep 1

PMID 16133268

Citations 17

Authors

Hiroyoshi Matsuoka

Tadahiko Masaki

Masanori Sugiyama

Yutaka Atomi

Affiliations

Soon will be listed here.

Abstract

Background And Aim: Lateral pelvic lymph node dissection (LPLD) has been reported to be beneficial in terms of survival for locally advanced low rectal carcinoma. However, the impact of LPLD on bowel function has not yet been determined by means of anorectal physiologic investigation.

Patients And Methods: Fifty-seven rectal cancer patients who underwent low anterior resection were evaluated with clinical and physiologic parameters. Of these, 15 patients had LPLD. The postoperative bowel and urinary function were evaluated with patients' questionnaire and anorectal manometry before and after the operation.

Results: The proportion of patients who had pouch reconstruction, adjuvant radiation therapy, and autonomic nerve dissection were significantly higher in the LPLD group. The incidence of evacuatory dysfunction was significantly higher (80% vs 45%) postoperatively in the LPLD group. There was no significant difference in anal sphincter pressures, sensory threshold, and neorectal volumes between the groups postoperatively. In terms of urinary function, use of medication for urination was significantly frequent in the LPLD group. Multivariate analysis identified the level of anastomosis as an independent affecting factor for evacuatory dysfunction and LPLD for urinary dysfunction.

Conclusion: Although LPLD affected urinary dysfunction, it did not impair postoperative evacuatory function in the early postoperative period.

Citing Articles

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Identification of lateral pelvic nodes without metastasis in patients with rectal cancer treated with preoperative chemoradiotherapy or chemotherapy based on magnetic resonance imaging.

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Transanally assisted lateral pelvic lymph node dissection for rectal cancer.

Matsuda T, Sawada R, Hasegawa H, Yamashita K, Utsumi M, Harada H Surg Endosc. 2022; 37(2):1562-1568.

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Robotic surgery contributes to the preservation of bowel and urinary function after total mesorectal excision: comparisons with transanal and conventional laparoscopic surgery.

Miura T, Sakamoto Y, Morohashi H, Suto A, Kubota S, Ichisawa A BMC Surg. 2022; 22(1):147.

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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 G, Davies R, Arezzo A, Bagolini F, DAndrea V, Graziosi L Int J Colorectal Dis. 2021; 36(11):2321-2333.

PMID: 34125269 PMC: 8505280. DOI: 10.1007/s00384-021-03946-2.

References

STEARNS Jr M, DEDDISH M . Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum. Dis Colon Rectum. 1959; 2(2):169-72. DOI: 10.1007/BF02616711. View

Hida J, Yasutomi M, Maruyama T, Tokoro T, Uchida T, Wakano T . Horizontal inclination of the longitudinal axis of the colonic J-pouch: defining causes of evacuation difficulty. Dis Colon Rectum. 1999; 42(12):1560-8. DOI: 10.1007/BF02236207. View

Matsushita K, Yamada K, Sameshima T, Niwa K, Hase S, Akiba S . Prediction of incontinence following low anterior resection for rectal carcinoma. Dis Colon Rectum. 1997; 40(5):575-9. DOI: 10.1007/BF02055382. View

Enker W, Thaler H, Cranor M, Polyak T . Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg. 1995; 181(4):335-46. View

Lewis W, Martin I, Williamson M, Stephenson B, Holdsworth P, Finan P . Why do some patients experience poor functional results after anterior resection of the rectum for carcinoma?. Dis Colon Rectum. 1995; 38(3):259-63. DOI: 10.1007/BF02055598. View

Romanos J, Stebbing J, Smiligin Humphreys M, Takeuchi N, Mortensen N . Ambulatory manometric examination in patients with a colonic J pouch and in normal controls. Br J Surg. 1996; 83(12):1744-6. DOI: 10.1002/bjs.1800831226. View

Hallbook O, Pahlman L, Krog M, Wexner S, Sjodahl R . Randomized comparison of straight and colonic J pouch anastomosis after low anterior resection. Ann Surg. 1996; 224(1):58-65. PMC: 1235247. DOI: 10.1097/00000658-199607000-00009. View

Shirouzu K, Ogata Y, Araki Y . Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer. Dis Colon Rectum. 2004; 47(9):1442-7. DOI: 10.1007/s10350-004-0618-8. View

JORGE J, Wexner S . Etiology and management of fecal incontinence. Dis Colon Rectum. 1993; 36(1):77-97. DOI: 10.1007/BF02050307. View

10.

Matsuoka H, Nakamura A, Masaki T, Sugiyama M, Takahara T, Hachiya J . A prospective comparison between multidetector-row computed tomography and magnetic resonance imaging in the preoperative evaluation of rectal carcinoma. Am J Surg. 2003; 185(6):556-9. DOI: 10.1016/s0002-9610(03)00067-9. View

11.

Ueno H, Mochizuki H, Hashiguchi Y, Hase K . Prognostic determinants of patients with lateral nodal involvement by rectal cancer. Ann Surg. 2001; 234(2):190-7. PMC: 1422005. DOI: 10.1097/00000658-200108000-00008. View

12.

Morita T, Murata A, Koyama M, Totsuka E, Sasaki M . Current status of autonomic nerve-preserving surgery for mid and lower rectal cancers: Japanese experience with lateral node dissection. Dis Colon Rectum. 2003; 46(10 Suppl):S78-87. DOI: 10.1097/01.DCR.0000089111.95420.BD. View

13.

Matsuoka H, Masaki T, Sugiyama M, Atomi Y . Large contractions in the colonic J-pouch as a possible cause of incomplete evacuation. Langenbecks Arch Surg. 2004; 389(5):391-5. DOI: 10.1007/s00423-004-0499-2. View

14.

DEDDISH M . Abdominopelvic lymphnode dissection in cancer of the rectum and distal colon. Cancer. 1951; 4(6):1364-6. DOI: 10.1002/1097-0142(195111)4:6<1364::aid-cncr2820040618>3.0.co;2-m. View

15.

Fujita S, Yamamoto S, Akasu T, Moriya Y . Lateral pelvic lymph node dissection for advanced lower rectal cancer. Br J Surg. 2003; 90(12):1580-5. DOI: 10.1002/bjs.4350. View

16.

Heald R, Ryall R . Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986; 1(8496):1479-82. DOI: 10.1016/s0140-6736(86)91510-2. View

17.

Havenga K, Enker W, Norstein J, Moriya Y, Heald R, van Houwelingen H . Improved survival and local control after total mesorectal excision or D3 lymphadenectomy in the treatment of primary rectal cancer: an international analysis of 1411 patients. Eur J Surg Oncol. 1999; 25(4):368-74. DOI: 10.1053/ejso.1999.0659. View

18.

Furst A, Suttner S, Agha A, Beham A, Jauch K . Colonic J-pouch vs. coloplasty following resection of distal rectal cancer: early results of a prospective, randomized, pilot study. Dis Colon Rectum. 2003; 46(9):1161-6. DOI: 10.1007/s10350-004-6707-x. View

19.

Hallbook O, Nystrom P, Sjodahl R . Physiologic characteristics of straight and colonic J-pouch anastomoses after rectal excision for cancer. Dis Colon Rectum. 1997; 40(3):332-8. DOI: 10.1007/BF02050425. View

20.

Morikawa E, Yasutomi M, Shindou K, Matsuda T, Mori N, Hida J . Distribution of metastatic lymph nodes in colorectal cancer by the modified clearing method. Dis Colon Rectum. 1994; 37(3):219-23. DOI: 10.1007/BF02048158. View