Journal articles: 'Lateral lymph nodes'

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Qian, XiaoYu, Jian Tang, Yongquan Chu, Liang Chen, Ziqiang Chen, and Lin Li. "Application of Carbon Nanoparticle Tracers in the Lateral Neck Lymph Nodes of CN1bx Patients with Papillary Thyroid Carcinoma." Journal of Nanoscience and Nanotechnology 21, no. 11 (November 1, 2021): 5408–13. http://dx.doi.org/10.1166/jnn.2021.19472.

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This study aimed to investigate the applicability of carbon nanoparticle tracers in the lateral neck lymph nodes of CN1bx patients with papillary thyroid carcinoma surgery. 73 patients with papillary thyroid carcinoma at our hospital between January 2019 to December 2019 were suspected metastasis in the lateral neck lymph node before surgical treatment. During the operation, carbon nanoparticle tracers were used as black staining tracers for the lateral neck lymph nodes to detect metastasis in each Compartment of the neck. The lateral Compartment is defined as level ll-V The black-stained lymph nodes, dyed by Carbon nanoparticle tracers, and non-dyed lymph nodes were compared. Post-surgery paraffin pathology was adopted as the gold standard to calculate the predictive performance of the carbon nanoparticle tracers in detecting lymph node biopsy metastasis. 59 of the patients (80.8%) had lateral neck metastasis. The black-stained lymph nodes, dyed by Carbon nanoparticle tracers, in Compartment IV exhibited the highest proportions in the case number submitted for detection and in lymph nodes metastasis, followed by Compartment III. The metastasis rate of the dyed lymph nodes in areas III and IV was significantly higher than that of non-dyed lymph nodes (P < 0.05). The sensitivity and accuracy of the dyed lymph node biopsy in Compartments III—IV were 90% and 93.2%, respectively. This predictive performance was similar to that Compartments ll-V combined. In conclusion, when carbon nanoparticle tracers are used for lymph node biopsy, high sensitivity and accuracy are obtained in lateral neck compartments III—IV, making these compartments ideal for lymph node biopsy.

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Graceffa, Giuseppa, Giuseppina Orlando, Gianfranco Cocorullo, Sergio Mazzola, Irene Vitale, Maria Pia Proclamà, Calogera Amato, et al. "Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation." Journal of Clinical Medicine 10, no. 15 (July 30, 2021): 3407. http://dx.doi.org/10.3390/jcm10153407.

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Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).

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Baytinger, V. F., O. S. Kurochkina, E. G. Zvonarev, and A. A. Loyt. "Postmastectomic lymphedema prevention: modern possibilities." Issues of Reconstructive and Plastic Surgery 24, no. 2 (August 31, 2021): 15–27. http://dx.doi.org/10.52581/1814-1471/77/02.

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A three-dimensional computer model of the topographic and anatomical variants of the lymph nodes in the axillary fossa gives reason to doubt the indisputability of the known data on the normal anatomy of the lymph nodes. This mainly concerns the presence of a lateral (shoulder) group of axillary lymph nodes (4-6 nodes), which can be located not only on the medial, but also on the posterior surface of the shoulder. In some cases, this group of axillary lymph nodes is generally absent in its typical place and is in close proximity to the central (intermediate) group of lymph nodes. Attention to the lateral (shoulder) group of lymph nodes is due to the fact that through them lymph drainage occurs from the entire superficial (epifascial) lymphatic system of the volar surface of the upper limb (skin and subcutaneous tissue). From the lateral group of lymph nodes, lymph drainage goes either to the central group or to the deltapectoral lymph nodes. In the course of axillary lymph node dissection of I, II and III levels in breast cancer, it is possible to save only the deltapectal lymph node with its afferent and efferent vessels, which provides full-fledged lymphatic drainage from the dorsolateral surface of the upper limb. But in this situation, without lymphatic drainage (superficial and deep) with preserved lymph production, the inner (volar) part of the upper limb remains, where lymphostasis begins to develop. An exception is the variant of localization of the brachial group of lymph nodes on the posterior surface of the shoulder, in which it is possible to preserve the lateral group of lymph nodes, which does not fall into the block of adipose tissue with other regional lymph nodes, and therefore partially preserve the lymph drainage from the medial surface of the ipsilateral upper limb towards the deltapectoral lymph node. Taking into account the topographic and anatomical variability of the lymph drainage collectors in the axillary fossa and the varied nature of the involvement of lymph nodes in the metastatic process, in each clinical case, the standard preoperative mapping of axillary lymph nodes (reverse lymphatic mapping) does not allow predicting the risk and timing of the development of postoperative upper limb lymphedema. The advantage of our technology two-contrast fluorescent lymphography - is the possibility of visual differentiation of all elements of lymph drainage from the mammary gland (indocyanine green - ICG) and the ipsilateral upper limb (methylene blue - MB). According to the results of the study, it will be possible to clarify the localization of the lateral (shoulder) group of axillary lymph nodes, topographic and anatomical features of the lymphatic drainage collectors in the axillary fossa and indications for lymphovenous shunting for primary surgical prevention of postmastectomy lymphedema of the upper limb.

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Christou, Niki, Jeremy Meyer, Christophe Combescure, Alexandre Balaphas, Joan Robert-Yap, Nicolas C. Buchs, and Frédéric Ris. "Prevalence of Metastatic Lateral Lymph Nodes in Asian Patients with Lateral Lymph Node Dissection for Rectal Cancer: A Meta-analysis." World Journal of Surgery 45, no. 5 (February 4, 2021): 1537–47. http://dx.doi.org/10.1007/s00268-021-05956-1.

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AbstractImportanceRectal cancers occupy the eighth position worldwide for new cases and deaths for both men and women. These cancers have a high tendency to form metastases in the mesorectum but also in the lateral lymph nodes. The therapeutic approach for the involved lateral lymph nodes remains controversial.ObjectiveWe performed a systematic review and meta-analysis to assess the prevalence of metastatic lateral lymph nodes in patients with lateral lymph node dissection (LLND) for rectal cancer, which seems to be a fundamental and necessary criterion to discuss any possible indications for LLND.MethodsData sources–study selection–data extraction and synthesis–main outcome and measures. We searched MEDLINE, EMBASE and COCHRANE from November 1, 2018, to November 19, 2018, for studies reporting the presence of metastatic lateral lymph nodes (iliac, obturator and middle sacral nodes) among patients undergoing rectal surgery with LLND. Pooled prevalence values were obtained by random effects models, and the robustness was tested by leave-one-out sensitivity analyses. Heterogeneity was assessed using the Q-test, quantified based on the I2 value and explored by subgroup analyses.ResultsOur final analysis included 31 studies from Asian countries, comprising 7599 patients. The pooled prevalence of metastatic lateral lymph nodes was 17.3% (95% CI: 14.6–20.5). The inter-study variability (heterogeneity) was high (I2 = 89%). The pooled prevalence was, however, robust and varied between 16.6% and 17.9% according to leave-one-out sensitivity analysis. The pooled prevalence of metastatic lymph nodes was not significantly different when pooling only studies including patients who received neoadjuvant treatment or those without neoadjuvant treatment (p = 0.44). Meta-regression showed that the pooled prevalence was associated with the sample size of studies (p < 0.05), as the prevalence decreased when the sample size increased.ConclusionThe pooled prevalence of metastatic lateral lymph nodes was 17.3% among patients who underwent rectal surgery with LLND in Asian countries. Further studies are necessary to determine whether this finding could impact the therapeutic strategy (total mesorectal excision with LLNDversustotal mesorectal excision with neoadjuvant radiochemotherapy).

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Sato, Hiroshi, Yutaka Miyawaki, Masayasu Aikawa, Kojun Okamoto, Shinichi Sakuramoto, Shigeki Yamaguchi, and Isamu Koyama. "PS02.013: THORACOSCOPIC ESOPHAGECTOMY WITH RADICAL LYMPH NODE DISSECTION FOR THORACIC ESOPHAGEAL CARCINOMA IN THE LEFT LATERAL DECUBITUS POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 124. http://dx.doi.org/10.1093/dote/doy089.ps02.013.

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Abstract Background The rates of thoracoscopic esophagectomy performed in the prone and left lateral decubitus positions are similar in Japan. We retrospectively reviewed short term outcomes of thoracoscopic esophagectomy for esophageal cancer performed in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation in a single institution. This study aimed to evaluate the feasibility of applying this procedure. Methods Between July 2013 and March 2017, 83 patients with esophageal cancer underwent thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation. The thoracic procedure is performed as follows: The lymph nodes around the right recurrent laryngeal nerve are dissected. On the cranial side, the lymph node dissection is advanced to the level of the inferior thyroid artery. Then, the assistant rotates the trachea toward the ventral side, and the lymph nodes around the left recurrent laryngeal nerve are dissected. The middle and inferior mediastinal lymph nodes are dissected including supradiaphragmatic lymph nodes and the dorsal lymph nodes around the thoracic descending aorta. Then, the esophagus is transected using an automatic suture device. Finally, the tracheal bifurcation area lymph nodes are dissected. We retrospectively analyzed these patients. Results The completion rate of thoracoscopic esophagectomy was 94.0%, and the procedure was converted to thoracotomy in five patients, due to hemorrhage, severe adhesion. The mean intrathoracic operative time, intrathoracic blood loss, and number of dissected mediastinal lymph nodes were 220.0 min, 130.1 mL, and 22.0, respectively. Postoperative complications included pneumonia (8.4%), anastomotic leakage (16.9%), and recurrent nerve paralysis (8.4%). Postoperative (30d) mortality was 1/83 (1.2%) due to ARDS. Conclusion Standardization of the procedure for thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation, with a standardized clinical pathway for perioperative care led to favorable surgical outcomes. Disclosure All authors have declared no conflicts of interest.

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Aboelatta, Ibrahim H., Soliman A. El-Shakhs, Abd Elmieniem F. Mohammed, and Mohammed H. Milegy. "Role of pelvic lymphadenectomy in rectal cancer." International Surgery Journal 6, no. 6 (May 28, 2019): 1838. http://dx.doi.org/10.18203/2349-2902.isj20192150.

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Background: Rectal cancer constitutes about one third of all colorectal cancer cases. Total mesorectal excision has become the gold standard in rectal cancer treatment. However total mesorectal excision does not involve any approaches for lateral pelvic lymph nodes (LPLN), which may be asource of local recurrences. Tumor containing LPLN were reported to be found in about 10%-20% of the rectal cancer patients. In japan lateral pelvic lymph node metastasis is accepted to be curable with excision.Methods: This study included 20 patients presented to Menofia Hospital for elective colorectal re sections and LPLN dissection, in the period from July 2016 to January 2019.Results: This study on 13 male (65%), 7 female (35%), all patients included in the study underwent preoperative chemoradiation according to the technique described by Marks et al. with an overall administration of 45 cGy over 5 weeks. Dissection of 180 lymph nodes was retrieved (20%) lymph nodes pathologically were positive for malignancy.Conclusions: Lateral pelvic lymph nodes dissection is an important in rectal cancer treatment.

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Wu, Xin, Binglu Li, Chaoji Zheng, Wei Liu, Tao Hong, and Xiaodong He. "Risk Factors for Lateral Lymph Node Metastases in Patients With Sporadic Medullary Thyroid Carcinoma." Technology in Cancer Research & Treatment 19 (January 1, 2020): 153303382096208. http://dx.doi.org/10.1177/1533033820962089.

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Purpose: Medullary thyroid carcinoma is a rare endocrine malignancy; 75% of patients with this disease have sporadic medullary thyroid carcinoma. While surgery is the only curative treatment, the benefit of prophylactic lateral neck dissection is unclear. This study aimed to analyze the clinicopathological risk factors associated with lateral lymph node metastases and determine the indication for prophylactic lateral neck dissection in patients with sporadic medullary thyroid carcinoma. Methods: The medical records of patients with medullary thyroid carcinoma who were treated at our hospital between January 2002 and January 2020 were retrospectively reviewed; a database of their demographic characteristics, test results, and pathological information was constructed. The relationship between lateral lymph node metastases and clinicopathologic sporadic medullary thyroid carcinoma features were analyzed using univariate and multivariate analyses. Results: Overall, 125 patients with sporadic medullary thyroid carcinoma were included; 47.2% and 39.2% had confirmed central and lateral lymph node metastases, respectively. Univariate and multivariate analyses identified 2 independent factors associated with lateral lymph node metastases: positive central lymph node metastases (odds ratio = 9.764, 95% confidence interval: 2.610–36.523; p = 0.001) and positive lateral lymph nodes on ultrasonography (odds ratio = 101.747, 95% confidence interval: 14.666–705.869; p < 0.001). Conclusion: Medullary thyroid carcinoma is a rare endocrine malignancy. Lymph node metastases are common in patients with sporadic medullary thyroid carcinoma. Prophylactic lateral neck dissection is recommended for patients who exhibit positive central lymph node metastases and/or positive lateral lymph nodes on ultrasonography.

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Morohashi, Hajime, Yoshiyuki Sakamoto, Takuya Miura, Daichi Ichinohe, Kotaro Umemura, Takanobu Akaishi, Kentaro Sato, et al. "Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type." International Journal of Colorectal Disease 36, no. 6 (February 1, 2021): 1251–61. http://dx.doi.org/10.1007/s00384-021-03870-5.

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Abstract Purpose There are no reports showing the significance and effective range of dissection for patients with lateral lymph node metastasis (LLNM). This study aimed to investigate the indications for lateral lymph node dissection (LLND) in patients with LLNM based on prognostic factors and recurrence types. Methods We reviewed 379 patients with advanced rectal cancer who were treated with total mesorectal excision plus LLND. We analyzed background factors and survival times of patients who had LLNM to determine prognostic factors and recurrence types. Results Pathological LLNM occurred in 44 (11.6%). Among patients with LLNM, the predictors of poor prognoses, according to univariate analysis, were > 3 node metastases, the presence of node metastasis on both sides, and spreading beyond the internal iliac lymph nodes. Moreover, LLNM beyond the internal iliac region was found to be an independent prognostic risk factor. Twenty-eight of the 44 patients with lateral lymph node metastasis (64%) relapsed, 22 of whom had distant metastases and 11 of whom experienced local recurrences. Among the latter group, nine (20%) and two (5%) had recurrences in the central and lateral pelvis, respectively. Conclusion The therapeutic benefit of resection was high, especially in patients with ≤ 3 positive lateral lymph nodes, one-sided bilateral lymph node areas, and positive nodes localized near the internal iliac artery.

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Hacker, Neville F., Ellen Barlow, Stephen Morrell, and Katrina Tang. "Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival." Cancers 13, no. 22 (November 19, 2021): 5806. http://dx.doi.org/10.3390/cancers13225806.

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Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this risk. Methods: We included patients with vulvar cancer of any histological type, even if the cancer extended medially to involve the urethra, anus, or vagina. We excluded patients whose tumor extended (i) laterally onto the thigh, (ii) posteriorly onto the buttocks, or (iii) anteriorly onto the mons pubis. After resection, the inguinal nodes were divided into a medial and a lateral group, based on the lateral border of the femoral artery. Results: Between December 2010 and July 2018, 76 patients underwent some form of groin node dissection, and data were obtained from 112 groins. Approximately one-third of nodes were located lateral to the femoral artery. Positive groin nodes were found in 29 patients (38.2%). All patients with positive nodes had positive nodes medial to the femoral artery. Five patients (6.6%) had positive lateral inguinal nodes. The probability of having a positive lateral node given a negative medial node was estimated to be 0.00002. Conclusion: Provided the medial nodes are negative, medial inguino-femoral lymphadenectomy may suffice and should reduce lower limb lymphedema without compromising survival.

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Lee, Cortney Y., Samuel K. Snyder, Terry C. Lairmore, Sean C. Dupont, and Daniel C. Jupiter. "Utility of Surgeon-Performed Ultrasound Assessment of the Lateral Neck for Metastatic Papillary Thyroid Cancer." Journal of Oncology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/973124.

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Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management.

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Dorin, Vartolomei Mihai, Chibelean Calin Bogdan, Voidazan Septimiu, Martha Orsolya, Borda Angela, Boja Radu Mihail, and Dogaru Grigore Aloiziu. "How Far We Should Go with Pelvic Lymph Node Dissection on the Controlateral Side in Unifocal Muscle Invasive Bladder Cancer." Acta Medica Marisiensis 61, no. 3 (September 1, 2015): 180–83. http://dx.doi.org/10.1515/amma-2015-0047.

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Abstract Objectives. The purpose of this study was to determine the evolution of patients with unifocal lateral wall MIBC (muscle invasive bladder cancer) after cystectomy with PLND (pelvic lymph node disection) at the Urology Clinic in Tirgu Mures, and to determine tumor stage and lymph node status before and after radical cystectomy with PLND. Methods. This is a prospective study, conducted between 1 August 2012 to 31 July 2014 at Urology Clinic, with a median follow-up of 14 months (range 7-25). Inclusion criteria were: patients undergone cystectomy with PLND, and unifocal MIBC on the lateral wall of the bladder; exclusion criteria were: multiple bladder tumor, other location and clinical T stage > 3. Results. Forteen patients met the inclusion criteria, median age was 61 (range 55-72), 85.71 % were male. An increase in T3 patients was noticed from 1 to 5 cases, we noticed a decrease of N0 lymph nodes from 78.6% to 57.1% postoperatively and on the controlateral side the kappa coefficient between the preoperatively and postoperatively negative lymph nodes was 0.63. On the tumor side the most common location for positive lymph nodes was external iliac with 3 nodes (21.4 %) and obturator fossa with 4 nodes (28.6 %) and on the contralateral side 2 positive nodes (14.3 %, obturator fossa, external, internal and common iliac nodes). Conclusions. In unifocal bladder tumors, located on the lateral wall, PLND could be an alternative with comparable results with extended PLND especially in T1 and T2 patients associated with N0 before and after surgery.

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Colakoglu, Bulent, Deniz Alis, and Hulya Seymen. "Diagnostic Accuracy of Ultrasound for the Evaluation of Lateral Compartment Lymph Nodes in Papillary Thyroid Carcinoma." Current Medical Imaging Formerly Current Medical Imaging Reviews 16, no. 4 (May 7, 2020): 459–65. http://dx.doi.org/10.2174/1573405615666190619093618.

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Aims: To evaluate the diagnostic accuracy of ultrasound (US) assessing the lateral compartment lymph node metastasis in patients with primary papillary thyroid carcinoma (PTC), and to demonstrate the incidence and patterns of the lateral lymph node metastasis. Methods: We retrospectively reviewed 198 patients with primary PTC who underwent thyroidectomy in addition to modified lateral neck dissections (MLND) involving level II to level V due to clinically positive lateral neck disease. A skilled and experienced single operator performed all US examinations. Surgical pathology results were accepted as the reference method and sensitivity, specificity, and diagnostic accuracy of US in detecting metastatic lymph nodes established using level-by-level analysis. Results: In the study cohort, 10.1% of the patients had lateral compartment lymph node metastases without any central compartment involvement. For the lateral compartment, 48.5% had level II, 74.7% had level III, 64.6% had level IV, and 29.3% of the patients had level V metastasis. None of the patients had isolated level V metastasis. The sensitivity, specificity, and diagnostic accuracy of US in identifying lateral lymph compartment metastasis ranged from 87% to 91.4%, 92% to 98.6% 92.4% to 96%, respectively. However, the sensitivity (74.7%) and diagnostic accuracy (76.2%) of US significantly decreased for the central compartment while specificity (90%) remained similar. Conclusion: US performed by a skilled operator has an excellent diagnostic accuracy for the evaluation of lateral cervical lymph nodes in primary PTC; thus, might enable precise tailoring of the management strategies. Moreover, the high incidence of level V involvement favors MLND over selective approaches.

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Tokuoka, Masayoshi, Yoshihito Ide, Mitsunobu Takeda, Yasuji Hashimoto, Jin Matsuyama, Shigekazu Yokoyama, Takashi Morimoto, et al. "Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach." International Surgery 100, no. 3 (March 1, 2015): 417–22. http://dx.doi.org/10.9738/intsurg-d-14-00091.1.

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We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer.

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Ubukata, Mamiko, Michio Itabashi, Shimpei Ogawa, Tomoichiro Hirosawa, Yoshiko Bamba, Sayumi Nakao, and Shingo Kameoka. "Japanese D3 lymph node dissection in low rectal cancer with inferior mesenteric lymph node and/or lateral lymph node metastases." Journal of Clinical Oncology 33, no. 3_suppl (January 20, 2015): 530. http://dx.doi.org/10.1200/jco.2015.33.3_suppl.530.

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530 Background: The current Japanese Classification of Colorectal Carcinoma defines inferior mesenteric lymph nodes (IMLN) and lateral lymph nodes (LLN) as regional lymph nodes in rectal cancer. It states that these lymph nodes should be dissected when performing D3 dissection for rectal cancer. However, there is currently no consensus on the significance of Japanese D3 lymph node dissection in low rectal cancer. A retrospective study involving a large number of patients was conducted. Methods: The subjects were 2,743 patients registered in the multi-institutional registry of the Japanese Society for Cancer of the Colon and Rectum. The data were analyzed for outcomes in R0 cases with IMLN and/or LLN metastasis (IMLN(+)LLN(-) or IMLN(-)LLN(+) or IMLN(+)LLN(+)). Results: In the control group, 67 patients (2.7%) were considered positive for IMLN metastasis, 181 patients (7.4%) for LLN metastasis, and 34 patients (1.4%) for IMLN + LLN metastasis. The outcomes in the R0 cases with IMLN and/or LLN metastasis were 52.8% for 5-year RFS and 63.1% for 5-year OS, which were each better than for R1+R2 cases (5-year RFS 26.2%, p<0.0001; 5-year OS 30.5%, p<0.0001). Including only those with a total of seven or more metastatic lymph nodes, the outcomes in the R0 cases with IMLN and/or LLN metastasis were 53.6% for 5-year RFS and 64.9% for 5-year OS, which did not differ significantly from those for IMLN(-)LLN(-) cases (5-year RFS 54.4%, 5-year OS 55.2%) (RFS: p=0.9718, OS: p=0.4049). Conclusions: We confirmed that cases of IMLN and/or LLN metastasis in low rectal cancer tend to have a large total number of metastatic lymph nodes, but a good outcome can be expected if curative resection can be performed. These results demonstrate the value of radical Japanese D3 lymph node dissection in low rectal cancer with IMLN and/or LLN metastasis.

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Elsheekh, Abd Elfattah Tawfek, Khaled Omar Elkhateb, and Ahmed Mohamed Gouda Embaby. "Evaluation of Lateral Pelvic Lymph Nodes Involvement in Rectal Carcinoma." Egyptian Journal of Hospital Medicine 76, no. 5 (July 1, 2019): 4228–34. http://dx.doi.org/10.21608/ejhm.2019.43800.

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Kim, Wan Wook, Hyang Hee Choi, Jeeyeon Lee, Seung Ook Hwang, Ho Yong Park, Ji-Young Park, and Jin Hyang Jung. "BRAFV600ETest for Suspicious Lateral Lymph Nodes in Papillary Thyroid Cancer." Korean Journal of Endocrine Surgery 16, no. 2 (2016): 36. http://dx.doi.org/10.16956/kaes.2016.16.2.36.

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Kim, Wan Wook, Hyang Hee Choi, Jeeyeon Lee, Seung Ook Hwang, Ho Yong Park, Ji-Young Park, and Jin Hyang Jung. "BRAFV600ETest for Suspicious Lateral Lymph Nodes in Papillary Thyroid Cancer." Korean Journal of Endocrine Surgery 16, no. 2 (2016): 36. http://dx.doi.org/10.16956/kjes.2016.16.2.36.

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Ogura, Ichiro, Takashi Kaneda, Masataka Kato, Shintaro Mori, Junko Motohashi, and Kwangsoon Lee. "MR study of lateral retropharyngeal lymph nodes at different ages." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 98, no. 3 (September 2004): 355–58. http://dx.doi.org/10.1016/j.tripleo.2004.06.067.

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Matsuoka, Hiroyoshi, Tadahiko Masaki, Masanori Sugiyama, Yutaka Atomi, Yasuo Ohkura, and Atsuhiko Sakamoto. "Morphological characteristics of lateral pelvic lymph nodes in rectal carcinoma." Langenbeck's Archives of Surgery 392, no. 5 (March 23, 2007): 543–47. http://dx.doi.org/10.1007/s00423-007-0181-6.

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Iqbal, Muhammad, and Wirsma Arif Harahap. "Breasts and Lymphatic Tissue ; A Literature Review." Journal of Midwifery 5, no. 1 (February 22, 2021): 5. http://dx.doi.org/10.25077/jom.5.2.5-13.2020.

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The breasts begin to grow from the sixth week of the embryo in the form of ectodermal thickening along the milk line that lies from the axilla to the middle of the groin (inguinal). The blood supply comes from the internal mammary artery, which is a branch of A. subclavian. Additional bleeding originated from A. axillary through the branches of A. thoracic lateral, A. thoraco dorsalis, and A. thoraco acromialis. The return of blood through the veins follows the passage of the artery to the internal mammary V. and the axillary vein branches to the superior V. kava. Lymph capillaries are located under the epidermis with a diameter between 20 and 70 mm. Lymphangion, as a pacemaker is limited by valves and lymphatic endothelial cells, will initiate an intrinsic pulsation of lymph fluid flow. Extrinsic factors such as contraction of the skeletal muscles, massage, increased hydrostatic pressure by postural gravity can also affect the lymphatic flow rate.5,6 These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic vein and drain into the supraclavicular nodes. 4 The LVC is an important anatomical structure for the physiology of vascular lymph node transplantation (VLNT) .8 Lymph vessels in the upper limb travel axially from the fingers to the back of the hand and make direction to the elbow, travel to the anteromedial area at the top of the arm and connect to the axillary lymph nodes in the lateral area. An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes. 4 The LVC is an important anatomical structure for the physiology of vascular lymph node transplantation (VLNT) .8An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes. 4 An alternative route directly to the supraclavicular node can be identified. These lymphatic vessels run on the lateral side of the upper arm, parallel to the cephalic veins and drain into the supraclavicular nodes.

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Ogura, Atsushi, Stefan van Oostendorp, and Miranda Kusters. "Neoadjuvant (chemo)radiotherapy and Lateral Node Dissection: Is It Mutually Exclusive?" Clinics in Colon and Rectal Surgery 33, no. 06 (September 22, 2020): 355–60. http://dx.doi.org/10.1055/s-0040-1714239.

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AbstractThe importance of total mesorectal excision (TME) has been the global standard of care in patients with rectal cancer. However, there is no universal strategy for lateral lymph nodes (LLN). The treatment of the lateral compartment remains controversial and has gone to the opposite directions between Eastern and Western countries in the past decades. In the East, mainly Japan, surgeons consider LLN metastases as regional disease and have performed TME with lateral lymph node dissection (LLND) without neoadjuvant (chemo)radiotherapy ([C]RT) in patients with clinical Stage II/III rectal cancer below the peritoneal reflection. In the West, neoadjuvant radiotherapy or has been the standard, and surgeons do not perform LLND assuming the (C)RT can sterilize most lateral lymph node metastasis (LLNM). Recent evidences show that lateral nodes are the major cause of local recurrence after (C)RT plus TME, and LLND reduces local recurrence particularly from the lateral compartment. Probably a combination of the two strategies, that is, neoadjuvant (C)RT plus LLND, would be needed to improve outcomes in patients with lateral nodal disease.

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Di Meo, Giovanna, Francesco Paolo Prete, Giuseppe Massimiliano De Luca, Alessandro Pasculli, Lucia Ilaria Sgaramella, Francesco Minerva, Francesco Antonio Logoluso, Giovanna Calculli, Angela Gurrado, and Mario Testini. "The Value of Intraoperative Ultrasound in Selective Lateral Cervical Neck Lymphadenectomy for Papillary Thyroid Cancer: A Prospective Pilot Study." Cancers 13, no. 11 (May 31, 2021): 2737. http://dx.doi.org/10.3390/cancers13112737.

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(1) Background: Lymph node metastases from papillary thyroid cancer (PTC) are frequent. Selective neck dissection (SND) is indicated in PTC with clinical or imaging evidence of lateral neck nodal disease. Both preoperative ultrasound (PreUS) and intraoperative palpation or visualization may underestimate actual lateral neck nodal involvement, particularly for lymph-nodes located behind the sternocleidomastoid muscle, where dissection may also potentially increase the risk of postoperative complications. The significance of diagnostic IOUS in metastatic PTC is under-investigated. (2) Methods: We designed a prospective diagnostic study to assess the diagnostic accuracy of IOUS compared to PreUS in detecting metastatic lateral neck lymph nodes from PTC during SND. (3) Results: There were 33 patients with preoperative evidence of lateral neck nodal involvement from PTC based on PreUS and fine-needle cytology. In these patients, IOUS guided the excision of additional nodal compartments that were not predicted by PreUS in nine (27.2%) cases, of which eight (24.2%) proved to harbor positive nodes at pathology. The detection of levels IIb and V increased, respectively, from 9% (PreUS) to 21% (IOUS) (p < 0.0001) and from 15% to 24% (p = 0.006). (4) Conclusions: In the context of this study, IOUS showed higher sensitivity and specificity than PreUS scans in detecting metastatic lateral cervical nodes. This study showed that IOUS may enable precise SND to achieve oncological radicality, limiting postoperative morbidity.

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Golledge, Jonathan, and Harold Ellis. "The aetiology of lateral cervical (branchial) cysts: past and present theories." Journal of Laryngology & Otology 108, no. 8 (August 1994): 653–59. http://dx.doi.org/10.1017/s0022215100127744.

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AbstractFour theories have been suggested to explain the aetiology of lateral cervical cysts. Ascherson (1832) suggested that the cysts arose due to incomplete obliteration of branchial cleft mucosa, which remained dormant until stimulated to grow later in life. His (1886) suggested these cysts were vestiges of the precervical sinus. Wenglowski (1912) believed lateral cervical cysts developed from the third pharyngeal pouch (thymopharyngeal duct).A number of investigators during the 19th century noted the close relationship between lateral cervical cysts and lymphoid tissue (Lucke, 1861). Luschka (1848) suggested that cystic degeneration of cervical lymph nodes was the mechanism by which lateral cervical cysts were formed. This theory received little support until King (1949) studied the histology of a large number of lateral cervical cysts and concluded that these cysts resulted from cystic transformation of cervical lymph nodes.The evidence for and against these theories of aetiology is discussed. The debate is centred on a study of 20 patients with lateral cervical cysts operated on in the Department of Otolaryngology, Bedford Hospital, between January 1986 and December 1991. In all twenty cases the wall of the cyst was found to be composed of lymphoid tissue, histologically identical to that present in lymph nodes. The mean age of presentation was 31 years, and in no case was a tract or cord found which connected the cyst to the skin or pharynx.The evidence strongly suggests that lateral cervical cysts develop from the cystic transformation of cervical lymph nodes. Mechanisms by which this may occur are discussed.

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Nishida, Mitsuo, Sinya Yasuda, Isao Yamamura, Katsuaki Miyaki, Yosihiko Yokoe, Ken-ichiro Murakami, Natsuki Segami, Sigeyuki Fujita, and Tadahiko Iizuka. "Management of metastases to lateral retropharyngeal lymph nodes (Rouviere lymph nodes) in squamous cell carcinomas of the oral cavity." Journal of Japan Society for Oral Tumors 14, no. 1 (2002): 1–10. http://dx.doi.org/10.5843/jsot.14.1.

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Chand, Manish, and Meara Dean. "Mapping the Mesentery Using ICG." Clinics in Colon and Rectal Surgery 35, no. 04 (July 2022): 338–41. http://dx.doi.org/10.1055/s-0042-1748888.

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AbstractIndocyanine green (ICG) fluorescent imaging has been used in colorectal surgery to assess intraoperative blood flow to the colon. However, its use has expanded to allow imaging of the lymphatic drainage within the mesentery in cancer resections. This technique can been used for real-time visualization of lymph nodes, and the detection of sentinel lymph nodes, lateral sidewall nodes, metastatic lymph nodes, and peritoneal metastases. Ultimately, this provides a more informative map of the mesentery displaying lymphatics and blood flow. The technique is economical and easy to use by the surgeon intraoperatively. ICG lymphangiography has the potential to aid the surgeon to ensure complete lymphadenectomy is performed in cancer resections.

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Pavlov, Maja, Dragutin Kecmanovic, Predrag Kovacevic, Aleksandar Sepetkovski, Miljan Ceranic, and Aleksandar Stamenkovic. "Lateral lymphadenectomy in treatment of rectal carcinoma." Acta chirurgica Iugoslavica 50, no. 2 (2003): 81–86. http://dx.doi.org/10.2298/aci0302081p.

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The aim of this work is to present existence of the lateral lymphatic spread of metastases in patients with Dukes C low rectal carcinoma (60 % of all patients), located at or bellow peritoneal reflexion. Prospective clinical investigation analyzed the group of 64 patients (32 underwent lateral lymphadenectomy and 32 didn?t), all treated at 1st Surgical Clinic, Clinical Center of Serbia. Lateral lymphatic spread of metastases was proven by frozen section in 8 cases, so extensive lateral lymphadenectomy was performed. In the group of patients who underwent lateral lymphadenectomy, positive lymph nodes were registered in 18 patients (56,2%); in group of patients operated without lateral lymphadenectomy, metastatic lymph nodes were registered in 12 patients (37,5%). According to results of this investigation, method of lateral lymphadenectomy, as well as extensive lateral lymphadenectomy, is significant for exact determination of postoperative stage of the disease. Also, there is a significant increase in number of patients with Dukes C stage of the disease. In those patients, mesorectectomy alone is not sufficient.

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Abdurakhmanova, Z. M., M. R. Ramazanov, and E. I. Sigal. "Surgical component of lateral and central breast cancer treatment." Kazan medical journal 102, no. 4 (August 8, 2021): 479–85. http://dx.doi.org/10.17816/kmj2021-479.

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Aim. To improve the results of the surgical component in the treatment of a nodular form of breast cancer with lateral and central localization by analyzing hemoglobin oxygen saturation of arterial blood in the foci of breast cancer, regional lymph nodes and resection line of the breast. Methods. The study involved 175 patients with a nodular form of breast cancer with lateral and central localization (T23N12M0), including 86 in the main group and 89 in the comparison group. In the main group, hemoglobin oxygen saturation in arterial blood of the foci of breast cancer, parenchyma, pectoral muscles and regional lymph nodes was examined for spread of cancer during surgery for nodular breast cancer by using a device developed by us (patent RU 2581266). This examination was not performed in the comparison group. Histopathological examination of resection specimens revealed confirmation of the main foci of breast cancer and the presence of metastases in the regional lymph nodes and pectoral muscles of the breast. Statistical analysis of the data was performed by using the Statistica 10 software. The arithmetic mean, the standard error of the mean and the standard deviation were calculated for the quantitative indicators. Results. In the main group, 86 patients had no recurrence and metastases in the follow-up, while in the comparison group, cancer recurrence was identified in 89 patients and metastases was found during cytological and histological studies in 9 patients. Conclusion. Determination of hemoglobin oxygen saturation of arterial blood during surgery in the subclavian, axillary and subscapular lymph nodes as well as in the pectoralis major and minor muscles allows clarifying the distribution of breast cancer, specifying the scope of the operation and improving the results of the surgical component of breast cancer treatment (T23N12M0).

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Jiang, Jie, Xiuyi Yu, Guojun Geng, and Hongming Liu. "PS01.146: THE ANALYSIS OF THE SAFETY OF A MODIFIED LEFT RECURRENT LARYNGEAL LYMPH NODES DISSECTION IN THORACOSCOPIC ESOPHAGEAL CARCINOMA SURGERY." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 91. http://dx.doi.org/10.1093/dote/doy089.ps01.146.

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Abstract Background To explore the thoroughness and safety of a modified left recurrent laryngeal lymph nodes dissection in thoracoscopic esophageal carcinoma surgery. Methods Retrospectively analyzed the clinical data of 136 patients with the left recurrent laryngeal lymph nodes dissection from October 2015 to October 2017 in the First Hospital Affiliated to Xiamen University. 67 cases were divided to the traditional dissection group (double lumen endotracheal intubation, 90 ° lateral position) and 69 cases were classified to the modified dissection group (single cavity tracheal intubation, thoracic CO2 positive pressure ventilation, lateral prone position and esophageal suspension technology). Observed and compared the left laryngeal recurrent nerve lymph nodes cleaning and time, intraoperative complications including thoracic duct injury, tracheal injury, hoarseness and pneumonia. Results The cleaning time of the modified dissection group (23 + 8 min) was significantly less than that of the traditional cleaning group (32 plus or minus 5min) (P < 0.01). 5 patients occurred left laryngeal nerve injury in the modified dissection group, with statistically significance (P < 0.01), less than traditional dissection group of 12 patients. The modified dissection method improves the exposure of intraoperative field, the probability of thoracic duct and tracheal injury (1/69, 0/69) were lower than the traditional group (2/67, 1/67), but the difference was not statistically significant (P > 0.05). Moreover, there was no significant difference in lymph nodes metastasis and complications incidence rate (P > 0.05). Conclusion The modified dissection method, including single cavity tracheal intubation, thoracic CO2 positive pressure ventilation, lateral prone position and using esophageal suspension technology, can achieve good operation field exposure, the left recurrent laryngeal lymph nodes ‘the whole block’ cleaning, and the greatest degree protection of laryngeal recurrent nerve, thoracic duct, trachea and other organs damage. It is worthy of clinical popularization and application. Disclosure All authors have declared no conflicts of interest.

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Omurbaev, Almaz, Ishenbek Satylganov, Yuliya Gayvoronskaya, Rakhat Abirova, Ilkhamzhan Tokhtyev, and Gulnara Moldotasheva. "Micro-macroscopic anatomy of the lymphatic vessels and lymph nodes that form the parietal lymphatic pathways of the human thoracic cavity." Biomedicine 42, no. 4 (September 12, 2022): 817–19. http://dx.doi.org/10.51248/.v42i4.1836.

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Introduction: Many pathological processes such as infections, intoxications, and malignant tumors were spread through the lymphatic vessels of the thoracic cavity. In the present study, we investigated the anatomy of the lymphatic vessels and lymph nodes of the thoracic cavity in humans. Materials and methods: The examination was performed on 60 cadavers of fetuses (25), newborn children (14), children (11), and adults (10). Lymphatic vessels of the rib periosteum, costovertebral, costotransverse, and sternocostal joints, as well as parietal lymphatic vessels and lymph nodes of the thoracic cavity were studied. A comparative study of arterial, venous, and lymphatic vessels was carried out. Results: The parietal lymph nodes of the thoracic cavity include parasternal (localized along the course of the thoracic arteries and veins), paramammary (located near the lateral edge of the pectoralis major muscle), intercostal, paravertebral, and upper diaphragm. The efferent lymphatic vessels of the periosteum and perichondrium of the first three ribs go to the intercostal lymph nodes, to the parasternal, paravertebral and diaphragmatic lymph nodes. Conclusion: The presence of intercalated lymph nodes on the thoracic cavity is characteristic of the entire lymphatic system and should be considered in the pathology of the thoracic cavity.

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KITAHARA, Kotaro, Kaoru MIYASHITA, Yasuhiro OHHASHI, Kazuya YAMAGUCHI, Sinya ASAMI, and Yoshiya DAIKOKU. "Evaluation of Rectal Cancer Patients with Lateral Pelvic Lymph Nodes Metastases." Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 26, no. 6 (2001): 1429–33. http://dx.doi.org/10.4030/jjcs1979.26.6_1429.

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Suhardja, Thomas S., Kim‐Chi Phan‐Thien, and David Z. Lubowski. "Lateral pelvic lymph nodes: the next phase in rectal cancer surgery." ANZ Journal of Surgery 90, no. 7-8 (July 2020): 1226–27. http://dx.doi.org/10.1111/ans.15999.

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Ozawa, Heita, Hiroki Nakanishi, Junichi Sakamoto, Yoshiyuki Suzuki, and Shin Fujita. "Prognostic impact of the number of lateral pelvic lymph node metastases on rectal cancer." Japanese Journal of Clinical Oncology 50, no. 11 (July 20, 2020): 1254–60. http://dx.doi.org/10.1093/jjco/hyaa122.

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Abstract Background This study aimed to clarify the number of lateral pelvic lymph node metastases of colorectal cancer for which prognosis could be improved by dissection. Methods We analysed the data of 30 patients with lateral pelvic lymph node metastases of rectal cancer that underwent a total mesorectal excision with lateral pelvic lymph node dissection at our institute from 1986 to 2016. We performed survival analysis on the number of lateral pelvic lymph node metastases in each of these patients and identified an optimal cut-off point of the number of lateral pelvic lymph node metastases that would predict recurrence-free survival using the receiver operating characteristic curves and an Akaike information criterion value. Results The 5-year recurrence-free survival and overall survival of patients with one or two lateral pelvic lymph node metastases were significantly better than that of those with three or more (5-year recurrence-free survival, 63.3 vs. 0.0%, respectively; hazard ratio, 0.23; 95% CI, 0.07–0.72; P = 0.0124) (5-year overall survival, 68.2 vs. 15.6%, respectively; hazard ratio, 0.29; 95% CI, 0.09–0.92; P = 0.0300). All of the metastatic lateral pelvic lymph nodes in the group with one or two lateral pelvic lymph node metastases were restricted to the internal iliac artery or obturator nerve regions. Conclusions The cut-off number of lateral pelvic lymph node metastases in the internal iliac artery or obturator nerve regions of colorectal cancer cases in whom prognosis was improved by lateral pelvic lymph node dissection was 2; patients who had <3 lateral pelvic lymph node metastases had better prognoses than those with ≥3 lateral pelvic lymph node metastases.

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Caziuc, Alexandra, Diana Schlanger, Giorgiana Amarinei, Vlad Fagarasan, David Andras, and George Calin Dindelegan. "Preventing Breast Cancer-Related Lymphedema: Feasibility of Axillary Reverse Mapping Technique." Journal of Clinical Medicine 10, no. 23 (December 6, 2021): 5707. http://dx.doi.org/10.3390/jcm10235707.

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Introduction. Our study aimed to determine the feasibility of axillary reverse mapping (ARM) technique, the identification rate of ARM nodes and their metastatic involvement, as well as to identify the factors that influence the identification and metastatic involvement. Material and methods. In total, 30 breast cancer patients scheduled for axillary lymph node dissection were enrolled in our study. The lymphatic nodes that drain the arm were identified by injecting 1 mL of blue dye in the ipsilateral upper arm; then, the ARM nodes were resected along with the other lymph nodes and sent for histological evaluation. Results. Identification of ARM node was successful in 18 patients (60%) and 22.22% of the identified ARM lymph nodes had metastatic involvement. Patients with identified ARM nodes had a significant lower BMI and a statistically significant relationship between axillary lymph node status and ARM node metastases was proven. Most of ARM lymph nodes (96.3%) were found above the intercostobrachial nerve, under the axillary vein and lateral to the thoracodorsal bundle. Conclusions. The ARM procedure is easy to reproduce but might not be appropriate for patients with a high BMI. The rate of metastatic involvement of ARM nodes is significant and no factor can predict it, showing that the preservation of these nodes cannot be considered.

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Gavrilina, E., and A. Kolesnyk. "Morphogenesis lymph node of domestic pig." Naukovij vìsnik veterinarnoï medicini, no. 2(160) (November 24, 2020): 102–9. http://dx.doi.org/10.33245/2310-4902-2020-160-2-102-109.

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The visceral and somatic lymph nodes of a pig of domestic 1-120 day old were examined. Found that the lymph nodes have a common connective tissue capsule and different levels of fusion of individual subunits. In the center of each subunit, the capsule forms invaginations of the capsular trabecula, dividing the parenchyma of each structural unit into «Ʊ»-shaped structures, fused with lateral and lower parts. The number and degree of fusion of subunits is different and depends on the age of the animals and the location of the lymph node. The greatest degree of fusion of individual units of the lymph node was found in the superficial cervical and axillary I ribs. In the mandibular, superficial parotid and superficial inguinal lymph nodes, the segments are clearly contoured already in newborn piglets. Segments are predominantly bean-spherical in shape with a wide base. The fusion of the segments occurs in their central part, and on the surface the gates of the subunits are clearly contoured in the form of numerous depressions. In the visceral lymph nodes, the portal and splenic lymph nodes have the smallest segmentation, and the gastric, tracheobronchial, and iliocolic lymph nodes are the largest. The number of segments varies from two in newborn piglets to five in 120-day-old pigs. The variability of the morphometric parameters of the lymph nodes of a domestic pig is due to a different number of afferent lymphatic vessels, and, accordingly, to different scales of the lymphatic basins. Thus, the lymph nodes of the domestic pig are complexes of subunits fused to varying degrees. Somatic lymph nodes are highly segmented. The degree of consolidation of subunits in the visceral lymph nodes is less pronounced. Linear measurements of organs vary depending on the age of the animals, gradually increasing up to 120 days with a tendency for these indicators to prevail in the somatic lymph nodes. Key words: domestic pig, lymph node, subunit, topography, morphometry

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Ohue, Masayuki, Shin Fujita, Junki Mizusawa, Yukihide Kanemitsu, Tetsuya Hamaguchi, Shunsuke Tsukamoto, Shingo Noura, et al. "Preoperative and postoperative prognostic factors of patients with stage II/III lower rectal cancer without neoadjuvant therapy in the clinical trial (JCOG0212)." Japanese Journal of Clinical Oncology 52, no. 2 (December 2, 2021): 114–21. http://dx.doi.org/10.1093/jjco/hyab183.

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Abstract Background The JCOG0212 trial was a randomized controlled trial comparing mesorectal excision alone to mesorectal excision with lateral lymph node dissection for stage II/III lower rectal cancer patients without clinical lateral lymph node enlargement. This study aimed to identify clinicopathological prognostic factors for relapse-free survival and overall survival of lower rectal cancer in the trial. Methods Prospective data were selected from 663 patients with complete data. Uni and multivariable Cox regression model was applied to evaluate the preoperative and the combined preoperative and postoperative factors, respectively. Preoperative factors included age, sex, performance status, clinical T, clinical N and operative procedures. Postoperative factors included histological grade, pathological T, number of metastatic lymph nodes and number of dissected lymph nodes. No patient received neoadjuvant treatment. Results Regarding preoperative factors, multivariable analysis revealed that performance status 1 (vs. 0: HR 2.079, P = 0.0041) and cT4a (vs. cT2–3: HR 2.721, P = 0.0002) were independent risk factors for relapse-free survival, and those for overall survival were male (vs. female: HR 1.660, P = 0.0228) and cT4a (vs. cT2–3: HR 2.486, P = 0.0473). The only independent preoperative risk factor common for relapse-free survival and overall survival was cT4a. Taking preoperative and postoperative factors together, the number of metastatic lymph nodes was the only independent risk factor common for relapse-free survival and overall survival. Conclusions Clinical stage II/III lower rectal cancer patients with cT4a should be a target of therapeutic development of neoadjuvant therapy. Postoperatively, intensive chemotherapy should be investigated for patients with more metastatic lymph nodes.

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Oshikiri, Taro, Tetsu Nakamura, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Satoshi Suzuki, and Yoshihiro Kakeji. "VS01.04: RELIABLE SURGICAL TECHNIQUES FOR LYMPHADENECTOMY ALONG THE LEFT RECURRENT LARYNGEAL NERVE DURING THORACOSCOPIC ESOPHAGECTOMY IN THE PRONE POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 44. http://dx.doi.org/10.1093/dote/doy089.vs01.04.

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Abstract Description Background Lymphadenectomy along the left recurrent laryngeal nerve (RLN) in esophageal cancer is important for disease control but requires advanced dissection skills. Complete dissection of the lymph nodes along the left RLN in a safe manner is important. We demonstrate the reliable method for lymphadenectomy along the left RLN during thoracoscopic esophagectomy in the prone position (TEP). Methods This procedure is performed for all of resectable thoracic esophageal cancers. The essence of this method is to recognize the lateral pedicle as a two-dimensional membrane that inclu replicatedes the left RLN, lymph nodes around the nerve, and primary esophageal arteries. By drawing the proximal portion of the divided esophagus and the lateral pedicle, identification and reliable cutting of the primary esophageal arteries and distinguishing the left RLN from the lymph nodes are simplified. Results We performed 46 TEPs for esophageal cancer using this method with no conversion to an open procedure in 2015 at Kobe University. No intraoperative morbidity related to the left RLN was observed. The mean number of harvested lymph nodes along the left RLN was 6.9 ± 4.2. Left RLN palsy greater than Clavien-Dindo classification grade II occurred in 4 patients (8%), all of them were reversible. The incidence of lymph node metastasis along the left RLN was 22%. Conclusion Our method for lymphadenectomy along the left RLN during TEP is safe and reliable. It has a low incidence of left RLN palsy and provides sufficient lymph node dissection along the left RLN. Disclosure All authors have declared no conflicts of interest.

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Kadhim, Salah Hadi, Karrar Ibrahim Mahmood, and Mohammed Mohammud Habash. "The Role of Prophylactic Cervical Lymph Node Dissection with Total Thyroidectomy in Prevention Recurrence of Papillary Thyroid Carcinoma." Open Access Macedonian Journal of Medical Sciences 10, B (May 10, 2022): 1372–76. http://dx.doi.org/10.3889/oamjms.2022.9436.

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AIM: It is assess benefit prophylactic selective unilateral cervical lymph node (LN) dissection with total thyroidectomy for patients who have papillary thyroid carcinoma (PTC) and negative cervical lymph nodes metastasis and determination recommended risk factors for such surgery. METHODS: This was a prospective study, 60 patients with PTC investigated by Fine needle aspiration, ultrasonography to support diagnosis patients with PTC, and negative lymph node metastasis. Nineteen patients are excluded from the entire 60 patients; remaining 41 patients are submitted to a total thyroidectomy and prophylactic selective one side ipsilateral lateral and central lymph nodes dissection (level II, III, IV, and V). Then, follow-up 2 years for all patients, postoperatively, for detection PTC recurrence. RESULTS: The result shows that from the total 41 patients, two groups are positive and negative lymph nodes metastasis 24.4% (10) and 75.6% (31), respectively, positive lymph nodes metastasis is presented more in male 7 (70%) with significant difference (p = 0.03) and age groups <55 years old 6 (60%) with insignificant association (p = 0.413). Thyroid nodular size (>1 cm) and multiple nodules presented more in positive lymph nodes metastasis with significant difference in both. Multivariate binary logistic regression, sex, thyroid multinodularity, and thyroid nodule size were insignificant relationship of prediction of lymph nodes metastasis. CONCLUSION: Prophylactic cervical LN dissection with total thyroidectomy for patients with PTC and negative cervical lymph nodes metastasis has beneficial role in preventing recurrence of PTC. Risk factors such as male gender, thyroid multinodularity (multiple nodule), and their size (>1 cm) have role in increasing chance of occurrence of cervical LN metastasis.

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Agarwal, Sudhi, Gyan Chand, Sushila Jaiswal, Anjali Mishra, Gaurav Agarwal, Amit Agarwal, A. K. Verma, and S. K. Mishra. "Pattern and Risk Factors of Central Compartment Lymph Node Metastasis in Papillary Thyroid Cancer: A Prospective Study from an Endocrine Surgery Centre." Journal of Thyroid Research 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/436243.

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Lymphatic metastasis in papillary thyroid cancer (PTC) is eminent; however, the extent of central compartment lymph nodes dissection (CCD) is controversial and requires the knowledge of pattern and risk factors for central compartment lymph nodes metastasis (CCM). We did a prospective study of 47 cases with PTC who underwent total thyroidectomy (TT) with CCD with/without lateral lymph nodes dissection (LND). Clinicopathological profile including CCM as ipsilateral and contralateral was documented. On histopathology, the mean tumour size was3.57±2.42 cm 59.6% had CCM, which was bilateral in the majority (60.72%). The tumour-size was the most important predictor for lymph nodes metastasis-(P=0.018) whereas multicentricity-(P=0.002) and ipsilateral CCM-(P=0.001) were the predictors for contralateral CCM. The long-term morbidity of CCD done in primary setting is comparable with TT-alone. Bilateral CCD should be done with thyroidectomy in PTC, otherwise the risk of residual diseases and subsequent recurrence is high. The long-term morbidity is comparable in experienced hands.

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Suzuki, Masami, Kohtaro Eguchi, Shota Ida, Ryuhei Okada, Tomoyuki Kawada, and Takeshi Kudo. "Lateral lingual lymph node metastasis in tongue cancer and the clinical classification of lingual lymph nodes." JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY 26, no. 1 (2016): 71–78. http://dx.doi.org/10.5106/jjshns.26.71.

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Yokoyama, Shozo, Katsunari Takifuji, Tsukasa Hotta, Kenji Matsuda, Takashi Watanabe, Yasuyuki Mitani, Junji Ieda, and Hiroki Yamaue. "Survival benefit of lateral lymph node dissection according to the region of involvement and the number of lateral lymph nodes involved." Surgery Today 44, no. 6 (December 27, 2013): 1097–103. http://dx.doi.org/10.1007/s00595-013-0815-y.

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Yip, T. C. K., and G. N. Ege. "Determination of depth distribution of internal mammary lymph nodes on lateral lymphoscintigraphy." Clinical Radiology 36, no. 2 (January 1985): 149–52. http://dx.doi.org/10.1016/s0009-9260(85)80098-2.

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YAR, SHAHAR, IJAZ HUSSAIN SHAH, ABRAR AHMED JAVED, Abid Jamil, Abubaker Shahid, Muhammad Hafeez, Shaheena Perveen, Ahmed Ijaz Masood, Khalid Shabbir, and Shahid Rasool. "STAGE III A & B NON-SMALL CELL LUNG CANCER." Professional Medical Journal 14, no. 01 (March 10, 2007): 181–86. http://dx.doi.org/10.29309/tpmj/2007.14.01.3647.

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Stage IIIA Non- Small Cell Lung Cancer (NSCLC) is characterized by the presence of ipsilateral mediastinal and / or sub carinal nodal involvement (N2) associated with a T1 or T2 primary lesion or a T3 lesion associated either with positive hilar nodes (N1) or with N2 nodal disease. Stage IIIB disease is characterized by scalene, supra-clavicular, contra lateral mediastinal, or contralateral hilar lymph node involvement (N3) associated with any T category or a T4 primary tumor associated with any N category1. Patients with stage IIIA disease can be stratified into those with bulky and nonbulky disease, based upon the presence of lymph nodes >2 cm in short-axis diameter, or groupings of multiple smaller lymph nodes 2. Patients with bulky stage IIIA or those with stage IIIB disease are generally considered inoperable.

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Rahmat, Frhana, Ananth Kumar Marutha Muthu, Navarasi S Raja Gopal, Soh Jo Han, and Azura Sharena Yahaya. "Papillary Thyroid Carcinoma as a Lateral Neck Cyst: A Cystic Metastatic Node versus an Ectopic Thyroid Tissue." Case Reports in Endocrinology 2018 (October 18, 2018): 1–3. http://dx.doi.org/10.1155/2018/5198297.

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Papillary thyroid carcinoma is the most common thyroid malignancy and frequently metastasizes to regional lymph nodes. Occasionally, metastatic lymph nodes are palpable without the evidence of primary tumour. Papillary thyroid carcinoma of lateral neck cyst is a rare condition. It may arise from thyroid primary which underwent cystic degeneration or true malignant transformation of ectopic thyroid tissue. Herein, we reported two cases with preoperative diagnosis of benign lateral neck cyst but postoperative histopathological results showed primary papillary thyroid carcinoma. Ultrasonography and computed tomography of the neck in both cases showed no significant thyroid lesion. However, the patient in Case 2 was subjected for total thyroidectomy and histopathological results showed the origin of primary tumour. In conclusion, thorough investigations including total thyroidectomy are indicated in cases of papillary thyroid carcinoma of lateral neck cyst. This practice is to ensure that this type of thyroid cancer can be detected earlier because it has a very good prognosis if treated earlier.

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Lim, Raymond Z. M., Juin Y. Ooi, Jih H. Tan, Henry C. L. Tan, and Seniyah M. Sikin. "Outcome of Cervical Lymph Nodes Dissection for Thyroid Cancer with Nodal Metastases: A Southeast Asian 3-Year Experience." International Journal of Surgical Oncology 2019 (February 28, 2019): 1–6. http://dx.doi.org/10.1155/2019/6109643.

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Introduction. Therapeutic nodal dissection is still the mainstay of treatment for patients with lymph node metastases in many centres. The local data, however, on the outcome of therapeutic LND remains limited. Hence, this study aims to inform practice by presenting the outcomes of LND for thyroid cancer patients and our experience in a tertiary referral centre.Methods. This is a single-centre retrospective observational study in a Malaysian tertiary endocrine surgery referral centre. Patients who underwent total thyroidectomy with lymph node dissection between years 2013 and 2015 were included and electronic medical records over a 3-year follow-up period were reviewed. The outcomes of different lymph node dissection (LND), including central neck dissection, lateral neck dissection, or both, were compared.Results. Of the 43 subjects included, 28 (65.1%) had Stage IV cancer. Among the 43 subjects included, 8 underwent central LND, and 15 had lateral LND while the remaining 20 had dissection of both lateral and central lymph nodes. Locoregional recurrence was found in 16 (37.2%) of our subjects included, with no statistical difference between the central (2/8), lateral (7/15), and both (7/20). Postoperative hypocalcaemia occurred in 7 (16.3%) patients, and vocal cord palsy occurred in 5 (11.6%), whereas 9 patients (20.9%) required reoperation. Death occurred in 4 of our patients.Conclusion. High recurrence and reoperative rates were observed in our centre. While the routine prophylactic LND remains controversial, high risk patients may be considered for prophylactic LND. The long-term risk and benefit of prophylactic LND with individualised patient selection in the local setting deserve further studies.

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Yang, Xuyang, Tao Hu, Chaoyang Gu, Shuo Yang, Dan Jiang, Xueqin Deng, Ziqiang Wang, and Zongguang Zhou. "The Prognostic Significance of Isolated Tumor Cells Detected Within Lateral Lymph Nodes in Rectal Cancer Patients After Laparoscopic Lateral Lymph Node Dissection." Journal of Laparoendoscopic & Advanced Surgical Techniques 29, no. 11 (November 1, 2019): 1462–68. http://dx.doi.org/10.1089/lap.2019.0489.

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Vogrin, Andrej, Hana Besic, Nikola Besic, and Maja Marolt Music. "Recurrence rate in regional lymph nodes in 737 patients with follicular or Hürthle cell neoplasms." Radiology and Oncology 50, no. 3 (September 1, 2016): 269–73. http://dx.doi.org/10.1515/raon-2016-0025.

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Abstract Background Preoperative ultrasound (US) evaluation of central and lateral neck compartments is recommended for all patients undergoing a thyroidectomy for malignant or suspicious for malignancy cytologic or molecular findings. Our aim was to find out how frequent was recurrence in regional lymph nodes in patients with follicular or Hürthle cell neoplasm and usefulness of preoperative neck US investigation in patients with neoplasm. Patients and methods Altogether 737 patients were surgically treated because of follicular or Hürthle cell neoplasms from 1995 to 2014 at our cancer comprehensive center, among them 207 patients (163 females, 44 males; mean age 52 years) had thyroid carcinoma. Results Carcinoma was diagnosed in follicular and Hürthle cell neoplasm in 143/428 and 64/309 of cases, respectively. A recurrence in regional lymph nodes occurred in 12/207 patients (6%) during a median follow-up of 55 months. Among patients with carcinoma a recurrence in regional lymph nodes was diagnosed in follicular and Hürthle cell neoplasms in 2% and 14%, respectively (p = 0.002). Recurrence in regional lymph nodes was diagnosed in 3/428 of all patients with follicular neoplasm and 9/309 of all patients with Hürthle cell neoplasm. Conclusions Recurrence in lymph nodes was diagnosed in 0.7% of patients with a preoperative diagnosis of follicular neoplasm and 3% of patients with a Hürthle cell neoplasm. A recurrence in regional lymph nodes is rare in patients with carcinoma and preoperative diagnosis of follicular neoplasm. Preoperative neck ultrasound examination in patients with a follicular neoplasm is probably not useful, but in patients with Hurtle cell neoplasm it may be useful.

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Li, Cunfu, Jun Xiang, and Yunjun Wang. "Risk Factors for Predicting Lymph Nodes Posterior to Right Recurrent Laryngeal Nerve (LN-prRLN) Metastasis in Thyroid Papillary Carcinoma: A Meta-Analysis." International Journal of Endocrinology 2019 (March 31, 2019): 1–11. http://dx.doi.org/10.1155/2019/7064328.

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Objective. To evaluate the risk factors for predicting lymph nodes (LN) posterior to right recurrent laryngeal nerve metastasis in thyroid papillary carcinoma. Methods. PubMed, PMC, EMBASE, and the Cochrane Library were systematically searched for articles published spanning 30/06/2009-30/8/2018 using multiple search terms. Thirteen articles involving 10,014 patients were reviewed in our meta-analysis. Stata 15.1 software was used for the meta-analysis. Results. The rate of LN posterior to right recurrent laryngeal nerve (LN-prRLN) metastasis was 8.65%. Univariate analysis showed that age (P=0.001), gender (P<0.001), tumour size (P<0.001), lateral LN metastasis (P<0.001), extrathyroidal invasion (P<0.001), multifocality (P=0.005), capsule invasion (P<0.001), tumour location (P=0.076), lymph nodes anterior to right recurrent laryngeal nerve (LN-arRLN) metastasis (P<0.001), and central LN metastasis (P<0.001) were significantly associated with the increased incidence of LN-prRLN metastasis in thyroid papillary carcinoma. Conclusion. PTC patients aged <45, male, and with tumours>1 cm, lateral LN metastasis, extrathyroidal invasion, multifocality, capsule invasion, LN-arRLN metastasis, or central LN metastasis were significantly correlated with lymph nodes posterior to right recurrent laryngeal nerve metastasis, indicating LN-prRLN dissection.

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Otsuka, Koji, Satoru Goto, Tomotake Ariyoshi, Takeshi Yamashita, Kentaro Motegi, Rei Kato, Masahiro Kohmoto, et al. "RA04.03: MINIMALLY INVASIVE ESOPHAGECTOMY IN THE LEFT LATERAL DECUBITUS POSITION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 25. http://dx.doi.org/10.1093/dote/doy089.ra04.03.

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Abstract Background We initially performed minimally invasive esophagectomy in a left lateral decubitus position through 5 ports in 1996, and we have now treated over 900 cases using this approach. This position has many benefits, but it also has some drawbacks. We were able to operate with good results after we introduced artificial pneumothorax with CO2 insufflation in 2010. We investigated the short- and long-term outcomes of thoracoscopic surgery for esophageal cancer in the left lateral decubitus position at our institution. Methods From 1996 to 2016, 807 esophageal cancer patients were treated with minimally invasive esophagectomy in the left lateral decubitus position at our hospital. We compared the 289 cases treated in the early period (1996–2005) and 518 cases treated in the late period (2006–2016), in which the procedure was standardized and operator training was established Results The completion rate of thoracoscopic surgery was 99.5%, with the procedure switched to thoracotomy in only 3 patients in whom hemorrhage occurred. The mean intrathoracic operative time was 205.0 min, mean intrathoracic blood loss was 127.3 mL, and mean number of dissected mediastinal lymph nodes was 24.7. The postoperative complications were pneumonia (8.5%), anastomotic leakage (7.5%), and recurrent nerve paralysis (7.8%). The 5-year overall survival rate was 69.5%. Comparison of 289 cases treated in the early period (1996–2005) and 518 cases treated in the late period (2006–2016), revealed significant differences in mean intrathoracic blood loss (174.0 vs. 94.2 mL); number of dissected mediastinal lymph nodes (20.0 vs. 28.4); postoperative hospital stay (33.4 vs. 20.0 days, all P < 0.001); and postoperative anastomotic leakage (13.9% vs. 1.6%, P < 0.0001). In recent operation, we do not have recurrent laryngeal nerve paralysis and hoarseness after we take care of the micro anatomical layer, stretch and thermal damage of recurrent laryngeal nerve when we dissect the lymph node. Conclusion These data indicate significant improvements in intrathoracic blood loss, number of dissected mediastinal lymph nodes, anastomotic leakage, and postoperative hospital stay, reflecting continued improvement of minimally invasive esophagectomy performed in the left lateral decubitus position at our institution. Disclosure All authors have declared no conflicts of interest.

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Beederman, Maureen, and David W. Chang. "Supraclavicular lymph node transplant: a focus on technique." Plastic and Aesthetic Research 9, no. 9 (2022): 54. http://dx.doi.org/10.20517/2347-9264.2022.64.

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Physiologic surgical options, including vascularized lymph node transplant and lymphovenous bypass are becoming increasingly popular interventions for the treatment of lymphedema of both the upper and lower extremities. Many different lymph node donor sites have been described, including submental, lateral thoracic, superficial groin, supraclavicular, and various intraabdominal sites. This paper describes a step-by-step approach to the harvest of vascularized lymph nodes from the supraclavicular area, which is the preferred donor site for most patients with both upper and lower extremity lymphedema.

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Danforth, D. N., P. A. Findlay, H. D. McDonald, M. E. Lippman, C. M. Reichert, T. d'Angelo, C. R. Gorrell, N. L. Gerber, A. S. Lichter, and S. A. Rosenberg. "Complete axillary lymph node dissection for stage I-II carcinoma of the breast." Journal of Clinical Oncology 4, no. 5 (May 1986): 655–62. http://dx.doi.org/10.1200/jco.1986.4.5.655.

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We reviewed the complete axillary dissection specimens of 136 patients with stage I-II breast cancer to clarify the distribution of axillary lymph node metastases in this disease. Our series included 71 patients undergoing axillary dissection as part of a modified radical mastectomy (MRM) and 65 patients undergoing axillary dissection in conjunction with conservative surgery of the breast and definitive postoperative breast radiotherapy (CAD). These two groups of patients were comparable according to age, menopausal status, tumor size, and clinical stage. In all patients the pectoralis minor muscle was excised and all axillary tissue removed. Each specimen contained a median of 23 lymph nodes. The axillary levels (I, II, III) were determined according to the relationship of axillary tissue to the pectoralis minor muscle (lateral, inferior, medial). Thirty-nine percent of the lymph nodes were contained in level I, 41% in level II, and 20% in level III. There were no significant differences noted in the number of lymph nodes or in the distribution of lymph nodes according to axillary level between dissections performed as part of the MRM or those done as a single procedure (CAD). Sixty-five patients (47.8%) had one or more positive lymph nodes in their axillary specimen. The clinical and pathologic stage was determined and compared for all patients. Among patients judged to have a clinically negative axilla, 37.6% had histologically positive lymph nodes (clinical false-negative rate). For patients with a clinically positive axilla, 11.1% had, histologically, no evidence of metastatic disease (clinical false-positive rate). When the distribution of lymph node metastases according to axillary level was studied, it was found that 29.2% of lymph node-positive patients (or 14.0% of all patients) had metastases only to level II and/or III of the axilla, with level I being negative (skip metastases). This incidence of skip metastases was greater among clinically node-negative than among clinically node-positive patients, but was not related to the size or location of the primary tumor in the breast. In addition, it was found that 20.0% of lymph node-positive patients (or 9.6% of all patients) were converted from three or fewer to four or more positive nodes by analysis of lymph nodes contained in levels II and III. This conversion from three or fewer to four or more positive nodes was due primarily to information contained in level II, with level III contributing to a smaller degree.(ABSTRACT TRUNCATED AT 400 WORDS)

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Journal articles on the topic 'Lateral lymph nodes'

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