Impact of lateral lymph node dissection on urogenital function and surgical outcomes following neoadjuvant chemoradiotherapy and total mesorectal excision for rectal cancer: a systematic review and meta-analysis.

Hao-Zhu Liu, Xiao Bai, Xin-Mao Zhu, Dong-Qiu Dai

Abstract readSystematic ReviewMeta-Analysis

In one paragraph

Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Hao-Zhu Liu *Department of Surgical Oncology, Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, People's Republic of China.

Xiao Bai *Department of Surgical Oncology, Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, People's Republic of China.

Xin-Mao ZhuDepartment of Gastrointestinal Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, People's Republic of China.

Dong-Qiu DaiDepartment of Surgical Oncology, Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, People's Republic of China. dqdai@cmu.edu.cn.ORCID http://orcid.org/0000-0002-5611-7457

Funding

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6 · The paper itself

Abstract

backgroundThe management of locally advanced rectal cancer primarily involves total mesorectal excision (TME) following neoadjuvant chemoradiotherapy (nCRT). However, the benefits of additional lateral lymph node dissection (LLND) remains controversial. This study was conducted to assess the impact of LLND on postoperative urogenital function and surgical outcomes in this patient population.

methodsEleven studies involving 2,069 patients were included. Relevant studies were retrieved from databases including Cochrane Library, Embase, PubMed, and Web of Science. The outcomes were presented as weighted mean differences (WMDs) or odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I

resultsCompared to nCRT and TME alone, the addition of LLND was associated with a significantly higher risk of urinary dysfunction (OR = 5.94, 95% CI: 2.91-12.13, P < 0.001), particularly in patients with a body mass index (BMI) ≥ 25 kg/m

conclusionsLLND increases the risk of urinary dysfunction in rectal cancer patients undergoing TME after nCRT, with a notably higher risk of urinary complications in patients with BMI ≥ 25 kg/m

Indexed as

Lymph Node ExcisionPostoperative ComplicationsRectal NeoplasmsColorectal Surgical ProceduresHumansNeoadjuvant TherapyProctectomyTreatment OutcomeUrination DisordersLateral lymph node dissectionMeta-analysisNeoadjuvant therapyRectal cancerTotal mesorectal excisionUrinary dysfunction

Identifiers

PMID42557488

DOI10.1007/s00464-026-13242-1

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.