Yamaguchi T, Akiyoshi T
Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Tech Coloproctol. 2025 Feb 4;29(1):60. doi: 10.1007/s10151-024-03078-z.
Lateral lymph node dissection (LLND) for rectal cancer is a vital procedure to achieve en bloc removal of metastatic lateral lymph nodes with surrounding fat tissues, guided by precise anatomical landmarks. The anatomy of the lateral compartment, however, is not straightforward for the majority of surgeons. Inadequate knowledge of the vascular and neural anatomy may increase the risk of intraoperative complications such as bleeding, nerve injury and incomplete lymph node dissection. Minimally invasive surgery provides enhanced visualization of the surgical anatomy in the lateral compartment. Comprehensive knowledge of surgical anatomy is indispensable for successful LLND, and simplifying the anatomy into the planes makes the procedure accessible for surgeons. This article presents anatomical landmarks essential for standardizing the step-by-step procedures of LLND and review the literature. i.e., for safe implementation of the procedures.
直肠癌侧方淋巴结清扫术（LLND）是一项重要手术，旨在依据精确的解剖标志，将转移性侧方淋巴结及其周围脂肪组织整块切除。然而，对于大多数外科医生而言，侧方间隙的解剖结构并不简单。对血管和神经解剖知识的欠缺可能会增加术中诸如出血、神经损伤及淋巴结清扫不彻底等并发症的风险。微创手术可增强对侧方间隙手术解剖结构的可视化。全面的手术解剖知识对于成功实施LLND不可或缺，将解剖结构简化为平面可使外科医生更易操作该手术。本文介绍了标准化LLND分步手术过程所需的解剖标志并回顾相关文献，即确保手术安全实施。
