Department of Surgery, Chitose City Hospital, Chitose, Japan.
Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Asian J Endosc Surg. 2022 Jan;15(1):216-219. doi: 10.1111/ases.12975. Epub 2021 Aug 9.
Lateral lymph node (LLN) metastasis is one of the forms of local recurrence after surgery for lower rectal cancer. We here present a case of LLN recurrence of rectal cancer that was shown by laparoscopic lateral lymph node dissection (LLND) to have a complete pathological response to chemotherapy. A 58-year-old man underwent open low anterior resection for lower rectal cancer. After detection of right LLN recurrence 43 months after the operation, 11 cycles of capecitabine, oxaliplatin, and bevacizumab chemotherapy were administered. Laparoscopic right LLND was performed 55 months after the first operation. Pathological examination revealed no viable tumor cells in the dissected lymph nodes. The patient remains alive without recurrence 61 months after the first surgery and 6 months after laparoscopic LLND. Laparoscopic LLND for LLN recurrence of rectal cancer is feasible and should be considered a valid treatment option.
侧方淋巴结（LLN）转移是直肠癌手术后局部复发的形式之一。我们在此报告一例直肠癌 LLN 复发的病例，该病例通过腹腔镜侧方淋巴结清扫术（LLND）显示对化疗有完全的病理反应。一名 58 岁男性因低位直肠腺癌接受了开放性低位前切除术。术后 43 个月发现右侧 LLN 复发，给予卡培他滨、奥沙利铂和贝伐珠单抗化疗 11 个周期。首次手术后 55 个月行腹腔镜右侧 LLND。病理检查显示清扫的淋巴结中没有存活的肿瘤细胞。首次手术后 61 个月和腹腔镜 LLND 后 6 个月，患者无复发，仍存活。腹腔镜 LLND 治疗直肠癌 LLN 复发是可行的，应被视为一种有效的治疗选择。
