[Retroperitoneoscopic Resection of Para-Aortic Lymph Node Metastasis in Colorectal Cancer]

Para-aortic lymph node metastasis(PALNM)is classified as distant metastasis in colorectal cancer(CRC). Although the benefit of para-aortic lymph node dissection(PALND)for the CRC patients with PALNM suspected radiologically remains controversial, some reports have shown that the survival benefit for PALND in CRC patients with PALNM. Moreover, the report evaluating the extent of PALND showed that the patients treated with radical lymphadenectomy had better prognosis compared to those treated with targeted lymphadenectomy defined as the dissection of only swollen lymph nodes. We have performed the laparoscopic PALND for selected CRC patients with PALNM. Three radical dissections using retroperitoneoscopy have been performed in 9 CRC patients who underwent PALND in the last 6 years. Now, we show one of the effective cases treated with the retroperitoneoscopic radical resection. We additionally mention the effectiveness of the retroperitoneoscopic radical resection for the patients with PALNM. The retroperitoneoscopic resection resulted in more blood loss and longer operative time than laparoscopic resection, however, more lymph nodes were resected. The retroperitoneoscopic radical resection may be the preferable procedure for the CRC patients with PALNM, especially for the patients with multiple or extensively spread PALNM.