The Application Of Lateral Lymph Node Dissection In Middle/low Rectal Cancer

Objective:To evaluate the therapy value of lateral lymph node dissection(LLND)Method:Synthetically assessed the published literatures all about the applycation of lateral lympn node dissection of lower rectal cancer by meta analysis.Results:Finally 10 literatures were according with standard inculding 3989 patients.Among them,2174 patients underwent TME and LLND were in LLND group,while other 1815 patients underwent only TME were in non-LLND(NLLND)group.Intra-operative blood loss was greater in the LLND group than in the NLLND group(weighted mean difference=40.94,P=0.005<0.05).Five-year survival rate was higher in the LLND group than in the NLLND group(73.1%VS65.8%;OR=1.29;95%CI:1.09—1.52;P=0.003<0.05).Local recurrence rate was less in the LLND group than in the NLLND group(7.6%VS13.8%;OR=0.54;95%CI:0.41—0.71;P<0.0001).The frequency of urinary dysfunction was significantly higher in the LLND group than in the NLLND group(46.7%VS5.7%;OR=14.62;95%CI:8.99—23.80;P<0.00001).The incidence of sexual dysfunction was lower in the NLLND group than in the LLND group(59.7%VS35.8%;OR=2.68,95%CI:1.89—3.78;P<0.00001).Conclusion: This Meta analysis showed that lateral lymph node dissection for lower rectal cancer have advantages in prolonging the 5-year survival rate and decreasing postoperative recurrence,while it can increase the amount of bleeding and elevate the incidence of urinary and sexual dysfunction.