Our data indicate that a complete AXLND can be performed with minimal long-term morbidity. The lower the morbidity of AXLND, the less acceptable are the unique complications of the SLN technique.
Identification of the SLN in colorectal cancer is technically possible in more than 90% of patients. However, SLN status correlates poorly with the true nodal status of the colorectal cancer, and the false-negative rate is 50%. This high false-negative rate is not clearly explained by extensive tumor burden, and it was also independent of gender, tumor stage, and type of lymphatic mapping technique. However, staging accuracy was lower in patients who underwent left-sided colorectal resection. Further studies are needed to clarify the limitations of lymphatic mapping in colorectal cancer.
The use of laparoscopic approaches to surgical disease continues to advance quickly. Laparoscopy applied to oncologic surgery continues to be debated. We review the experience of laparoscopy as it relates to surgery for tumors. Specifically, we discuss the physiologic changes and tumor response to laparoscopy, as well as the current concepts explaining port site recurrence.
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