Research Progress in Lateral Lymph Node Dissection (LLND) for Rectal Cancer

MIAOMIAO DONG¹ZHENGPENG QAIN^2,3JIYONG LU²JINGJING LI^2,4Binbin Du^2,4,5YAOCHUN LV²SHIYUN XU²DEWANG WU^2*

• ¹Gansu Province Hospital Rehabilitation Center, Lanzhou, Gansu Province, China
• ²Gansu Provincial Hospital, Lanzhou, China
• ³The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, Gansu Province, China
• ⁴Clinical Medical Research Center for Anorectal Diseases of Gansu Province, Lanzhou, Gansu Province, China
• ⁵The first Clinical Medical College of Lanzhou University, lanzhou, China

Lateral Lymph Node Dissection (LLND), a critical surgical intervention in the treatment system for patients with low rectal cancer, plays a pivotal role in clinical practice. Its core objective is to completely resect lateral pelvic lymph nodes, block the metastatic pathway of tumor cells to these lymph nodes, minimize the risk of postoperative recurrence to the greatest extent, and lay a solid foundation for the long-term survival of patients. In Japan, LLND has become a standard surgical procedure for low rectal cancer and is widely applied; however, in Europe and North America, neoadjuvant chemoradiotherapy (nCRT) is regarded as the dominant treatment standard, which has led LLND to become mired in controversy and face numerous doubts in clinical application. This article closely integrates the latest cutting-edge clinical research findings, thoroughly explores the trajectory of its technical evolution, analyzes its clinical efficacy, objectively presents the focal points of academic controversy, and prospectively looks into its future development. It aims to provide a comprehensive and multi-level professional analysis for the rational application and continuous optimization of this technique in the treatment of low rectal cancer.