Factors Associated With Preoperative Evaluation Of Selective Lateral Lymph Node Dissection For Middle And Low Rectal Carcinoma

Objective:To explore the risk factors of lateral lymph node metastasis in rectal cancer and to find the relevant factors for preoperative evaluation of selective lateral lymph node dissection.Method:To collect Forty-two rectal cancer patients who accepted lateral lymph node dissection in our department from December 2018 to December 2019.Unifactorial analysis was performed on basic case information and preoperative examination results to find relevant risk factors,and then logistic multivariate analysis was performed on screened risk factors to evaluate the correlation of risk factors.Result:A total of 42 cases were included in lateral lymph node dissection,including 8(19.0%)with positive metastasis.Six risk factors with statistical significance were screened by univariate analysis,including MRI tumor T stage,size of MRI lateral lymph nodes,regularity of border,evenness of signal intensity,and treatment response of tumor and lateral lymph nodes after neoadjuvant therapy.Logistic multivariate regression analysis of these factors showed that irregular rectal MRI lymph node boundary was an independent risk factor for lateral lymph node metastasis Conclusion : MRI tumor T stage,MRI lateral lymph node size,whether the edge is regular,whether the signal intensity is uniform,tumor and lateral lymph node treatment response after neoadjuvant therapy is a risk factor for colorectal cancer lateral lymph node metastasis,among which the irregular border of rectal MRI lymph node is an independent risk factor for lateral lymph node metastasis.Neoadjuvant therapy cannot replace lateral lymph node dissection in rectal cancer patients with clear clinical evidence of suspected lateral lymph node metastasis.