Kazuhiro Sakamoto1, Toshiaki Hagiwara1, Hirokazu Matsuzawa1, Shingo Kawano1, Shinya Kawai1, Koichiro Niwa1, Shun Ishiyama1, Kiichi Sugimoto1, Hirohiko Kamiyama1, Makoto Takahashi1, Yutaka Kojima1, Yuichi Tomiki1, Tetsu Fukunaga2, Yoshiaki Kajiyama2, Seiji Kawasaki2. 1Coloprocotological Surgery, Juntendo University Hospital, 2Gastroenterological Surger, Juntendo University Hospital
Aims: Isolated para-aortic lymph node (PALN) metastasis is a relatively rare type of metastasis in colorectal cancer. PALN metastases are frequently associated with other distant metastases, and their surgical management remains controversial. This study aimed to investigate the technical feasibility and oncological outcomes of laparoscopic PALN resection in patients with colorectal cancer.
Methods: This retrospective study was performed between July 2011 and December 2016 and included 7 patients who underwent laparoscopic PALN resection for colorectal cancer. Indications of laparoscopic PALN resection were as follows: (1) no other synchronous distant metastases except PALN; and (2) PALN metastasis located below the renal vein and without invading a major vessel. Five ports were placed, and if necessary, an additional port was inserted near the median line to avoid the operator’s instruments contacting the abdominal aorta.
Results: The median age was 67 years (range, 57–74 years), and 4 patients were men. The primary tumor was rectal cancer in 4 patients and colon cancer in 3. Six patients were clinically diagnosed with synchronous PALN metastasis, and 1 patient had metachronous PALN metastasis. Four patients received neoadjuvant chemotherapy before PALN resection. The median operating time was 423 min (range, 183–770 min), and the blood loss was 23 mL (range, 5–210 mL). There was no conversion to an open procedure. Postoperative complications occurred in 3 patients. However, the patients were conservatively treated. The median postoperative hospital stay duration was 16 days.
Conclusion: The results of our retrospective study suggest that laparoscopic PALN resection in patients with colorectal cancer may be a feasible approach for selected patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87126
Program Number: P256
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster