Abstract:

Dysfunction and strategy after lateral pelvic lymph node dissection in rectal cancer        HAN Jia-gang，WANG Zhen-jun. Department of General Surgery，Beijing Chaoyang Hosptial，Capital Medical University，Beijing 100020，China
Corresponding author：HAN Jia-gang，E-mail：hjg211@163.com
Abstract    Lateral lymph node dissection is a standard procedure for low rectal cancer in Japan，and is considered to increase the incidence of urinary and sexual dysfunction after surgery due to damage to the pelvic autonomic nerves. The autonomic nerve-preserving surgery might minimize the occurrence of postoperative dysfunction. Laparoscopic surgery has a magnification effect due to its clear vision and might help to protect the pelvic autonomic nerves. There are many preoperative factors to predict lateral lymph node metastasis，among which MRI examination is the most important，which can reduce unnecessary lateral lymph node dissection. Neoadjuvant therapy can help to reduce local recurrence rate. Some studies suggest that neoadjuvant therapy can replace lateral lymph node dissection. However，it still needs strong evidence to support.

Key words: rectal cancer, lateral lymph node dissection, pelvic autonomic nerves, laparoscopic surgery, neoadjuvant therapy

摘要：

侧方淋巴结清扫在日本是进展期低位直肠癌治疗的标准术式，但由于其可能损伤盆腔自主神经，故被认为增加术后排尿和性功能障碍发生率。保护盆腔自主神经的手术，在一定程度上可以减少术后功能障碍的发生。腹腔镜手术由于视野清晰，具有放大效果，有助于保护盆腔自主神经。目前，多种因素可以预测侧方淋巴结转移，其中以MRI检查最为重要，可以减少不必要的侧方淋巴结清扫。新辅助治疗有助于降低局部复发率，部分研究认为可以替代侧方淋巴结清扫，但尚无有力证据支持。

关键词: 直肠癌, 侧方淋巴结清扫, 盆腔自主神经, 腹腔镜手术, 新辅助治疗