Efficacy of inferior vesical vessels preservation in lateral lymph node dissection for rectal cancer: Short- and long-term outcomes

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Colorectal Disease Pub Date : 2025-02-13 DOI:10.1111/codi.70029

Sodai Arai, Hiroyasu Kagawa, Akio Shiomi, Shoichi Manabe, Yusuke Yamaoka, Chikara Maeda, Yusuke Tanaka, Shunsuke Kasai, Akifumi Notsu, Yusuke Kinugasa

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引用次数: 0

Abstract

Aim

Lateral lymph node dissection (LLD) is performed for rectal cancer, with some cases requiring resection of the inferior vesical vessels (IVV). However, whether preservation or resection of the IVV affects urinary dysfunction (UD) as a major complication or local recurrence (LR) is unclear. Thus, we assessed the effect of IVV resection on the short- and long-term outcomes of rectal cancer.

Method

This retrospective cohort study included patients who underwent robotic mesorectal excision with LLD between December 2011 and April 2021. The patients were divided into two groups based on preserved and resected IVV. Postoperative complications, including UD, and long-term outcomes, including cumulative LR and cumulative lateral local recurrence (LLR), were evaluated.

Results

Among 340 patients, 298 (87.6%) and 42 (12.4%) were included in the IVV preservation and resection groups, respectively. UD was more frequent (50% vs. 16.8%) in the IVV resection group than in the IVV preservation group (p < 0.01). In the multivariate analysis, IVV and autonomic nervous system resections were significantly associated with UD. The 3-year LR was 4.0% and 5.7% in the IVV preservation and resection groups, respectively (p = 0.99). The 3-year LLR was 2.1% and 0% in the IVV preservation and resection groups, respectively (p = 0.27).

Conclusion

IVV resection and autonomic nervous system resection were independent risk factors for UD in robotic LLD. IVV preservation, except in cases of necessity, improves patients’ quality of life and has favourable oncological outcomes.

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来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.