title: Laparoscopic radical correction combined with extensive lymphadenectomy and pelvic autonomic nerve preservation for mid-to-low rectal cancer.
abstract: OBJECTIVE
  The purposes of this study were to confirm the definite metastasis and micrometastasis rate of upward and lateral lymph nodes of mid-to-low rectal cancer at stage II and stage III, and to evaluate the feasibility and safety of laparoscopic radical correction combined with extensive lymphadenectomy and pelvic autonomic nerve preservation (PANP).
  
  
  METHODS
  The study was performed in 68 patients who were diagnosed with mid-to-low rectal cancer at stage II or stage III and received laparoscopic radical correction combined with extensive lymphadenectomy and PANP from June 2006 to June 2008 in the General Surgery Department of Southwest Hospital. All lymph nodes resected in the surgeries were examined by hematoxylin and eosin (H & E) stain and immunohistochemistry with an antibody against cytokeratin 20 (CK20) to confirm the conditions of metastasis and micrometastasis. We compared the postoperative complications with those of traditional surgeries.
  
  
  RESULTS
  In 1571 lymph nodes, 16 lymph nodes were found to have definite metastasis in 6 patients (8.8%) and in 41 lymph nodes we found micrometastasis in 12 patients (17.6%). The total metastasis rate of upward and lateral lymph nodes was 19.1%. Compared with traditional surgeries, the new surgery had less blood loss and short convalescence and postoperative complications were not increased.
  
  
  CONCLUSIONS
  The total metastasis rate of upward and lateral lymph nodes is 19.1%. The laparoscopic radical correction combined with extensive lymphadenectomy and PANP is feasible and safe.
authors.affiliation: Department of General Surgery, Southwest Hospital, Third Military Medical University, Chong Qing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.forename: Peiwu
authors.initials: P
authors.lastname: Yu
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.forename: Dongzhu
authors.initials: D
authors.lastname: Zeng
authors.forename: Lu
authors.initials: L
authors.lastname: Gan
authors.forename: Wei
authors.initials: W
authors.lastname: Lv
authors.forename: Liye
authors.initials: L
authors.lastname: Liu
authors.forename: Xiaochu
authors.initials: X
authors.lastname: Yan
mesh_terms: D017776:Autonomic Pathways / Q000473:pathology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D061206:Neoplasm Micrometastasis; D019635:Neurosurgical Procedures; D010388:Pelvis / Q000294:innervation* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*