[Clinical significance of No.253 lymph node dissection in rectal cancer]

The dissection of No.253 lymph nodes located at the root of the inferior mesenteric artery (IMA) is a key step in radical resection for rectal cancer. The clinical significance of this surgical procedure is evolving. There remains controversy regarding which rectal cancer cases with specific clinicopathological features can truly benefit from this operation. Current evidence suggests that No.253 lymph node dissection should be performed selectively in patients with high-risk factors or evidence suggesting metastatic involvement, and the procedure should be avoided in groups that cannot benefit from it. A personalized dissection strategy based on preoperative risk factors and imaging evaluation is expected to balance the need for radical tumor resection and postoperative functional protection, thereby optimizing the oncological outcomes and quality of life of rectal cancer patients. Future studies should focus on further exploration through prospective randomized controlled trials to identify the patient groups most likely to benefit from No.253 lymph node dissection, in order to pursue individualized surgical planning.