Meta-analysis Of Application Of Lateral Lymph Node Dissection For Low Rectal Cancer In China

Objective: To explore the value of the application of lateral lymph node dissection(LLND)for low rectal cancer in China.Methods:Computer retrieve China National Knowledge Infrastructure(CNKI),Wanfang Data,China Biology Medicine disc and other domestic medical database,collecting published all about domestic Lateral lymph node dissection(LLND)in the low post for the application of rectal cancer related literature between January 2004 and January 2020,Screening according to inclusion and exclusion criteria,using Review Manager 5.1 software for comprehensive analysis.Results: A total of 19 studies involved 2,954 eligible patients.There were 1494 cases in the LLND group and 1460 cases in the non-LLND(NLLND)group.The operative time of LLND group was significantly longer than that of NLLND group,and the weighted mean difference(WMD)was 39.01 min,and the discrepancy was statistically significant(P<0.00001).The intraoperative blood loss in LLND group was higher than that in NLLND group,with a combined weighted mean difference of 42.61 m L,and the discrepancy was statistically significant(P<0.00001).The 3-year survival rate of LLND group was higher than that of NLLND group(83.1% vs 67.0%),and the discrepancy was statistically significant(P<0.0001).The 5-year survival rate of LLND group was significantly higher than that of NLLND group(63.1% vs 51.2%),and the discrepancy was statistically significant(P<0.0001).The local recurrence rate of LLND was significantly lower than that of NLLND group(10.0% vs 18.4%),and the discrepancy was statistically significant(P<0.00001).Line stage Ⅰ and ⅡLLND there was no statistically significant difference to the influence that the local recurrence(Ⅰ period = 0.96,Ⅱ period = 0.05).Ⅲ period of low rectal cancer local recurrence LLND group was obviously lower than that of NLLND group(17.5% vs 26.6%),P<0.05 differences statistically significant(P = 0.02);The distant metastasis rate in LLND group was significantly lower than that in NLLND group(8.5% vs 22.3%),the discrepancy was statistically significant(P<0.0001).Conclusion: Lateral lymph pelvic node dissection in china patients with low rectal cancer can obviously prolong the patient’s 3-year survival rate5-year survival rate,decrease the rate of distant metastasis and local recurrence(especially in stage Ⅲ low rectal cancer)and improve the prognosis of patients with disease,but it increases the operative time and intraoperative blood loss.