[Lymphadenectomy in oncological visceral surgery-Part 2 : Cancer of the upper and lower intestinal tract]

Chirurg. 2019 Jun;90(6):505-521. doi: 10.1007/s00104-019-0963-8.
[Article in German]

Abstract

In cancers of the upper and lower intestinal tract the risk of lymphatic metastases depends on the histological results, tumor grading, and depth of tumor infiltration (T-stage). Pretherapeutic staging is of particular importance for determining the surgical strategy (local excision vs. en bloc resection with regional lymphadenectomy) as well as for evaluating the necessity of neoadjuvant therapy. While the first part on "Lymphadenectomy in oncological visceral surgery" focused on hepatobiliary and pancreatic cancer, this second part contains an overview of anatomical conditions of lymphatic drainage of the esophagus, stomach, duodenum, small intestine, colon, rectum and anus. Based on this, the principles and techniques of lymphadenectomy for cancer in these organs and the requirements on systematic regional lymphadenectomy in the actual TNM classification (8th edition) are discussed.

Keywords: Anal cancer; Anatomy of lymphatic drainage; Colorectal cancer; Esophageal cancer; Gastric cancer.

Publication types

  • Review

MeSH terms

  • Gastrointestinal Neoplasms* / pathology
  • Gastrointestinal Neoplasms* / surgery
  • Humans
  • Lymph Node Excision*
  • Lymphatic Metastasis
  • Neoplasm Staging