LYMPHADENECTOMY IN COLORECTAL CARCINOMA: REVIEW OF THE LITERATURE
Abstract:
Soon we will be able to stage patients without needing to remove the primary tumour and surrounding lymphatic tissue. Soon we will be able to predict which primary tumours have a predisposition to metastasize and where they will metastasize. Colon and rectal cancer continue to be among the highest incident solid tumours in males and females. In order to define the role of lymphadenectomy in colorectal carcinomas, the literature of past 20 years and the historic publications were reviewed. Special attention was given to statistical relevance, survival, surgical therapy, recurrence rates, lymphadenectomy, and which operation is the best to treat colorectal cancer. The guidelines recommend the radical en block resection of the tumour hearing bowel with central ligation of its vessels, although evidence supports this is limited. In colorectal cancer surgery, the systematic lymphadenectomy of the lymphatic drainage also the arterial blood supply are included in resection. The extent of intestinal resection is determined from the lymphatic dissection. The bowel resection is depending on the tumour depth invasion (pT). – a 5-10 cm resection margin proximally and distally. The lymph node status (pN) is one of the most important prognostic factors. The total number of lymph nodes can be influenced by the surgeon, patient and the pathologist. New studies exist,which show that only small subgroups of patients receive a prognostic benefit from radical lymphadenectomy and because we cannot yet identify these patients pre- or intraoperativly, we continue to perform radical lymphadenectomy. The role of the santinel lymph node (SLN) is yet unclear
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