Kết quả sớm vét hạch mạc treo tràng dưới tận gốc bảo tồn động mạch đại tràng trái trong ung thư trực tràng cao

Abstract

This descriptive study included 140 patients with upper rectal cancer who underwent inferior mesenteric root lymphadenectomy with left colic artery preservation at K Hospital (July 2017 - December 2025) to evaluate safety and early oncological outcomes. The mean age was 62.4 ± 11.0 years old, males represented 52.1%. Preoperatively, cT3-4 disease, clinically positive nodes, and stage III disease accounted for 87.9%, 66.4%, and 66.4%, respectively; 31.4% of patients received neoadjuvant treatment. The mean operative time was 110.5 ± 19.2 minutes and the mean hospital stay was 7.43 ± 0.83 days. The 30-day complication rate was 2.1%, with no instance of anastomotic leakage, reoperation, or mortality. The mean lymph node yield was 14.80 ± 5.83 (significantly higher in the upfront surgery group, p = 0.0496), pathological node positivity was 35.7%, and the positive circumferential resection margin (CRM) was 0.7%. Among neoadjuvant-treated patients, the pathological complete response (pCR) rate reached 20.5% and TNM downstaging was 72.7%. This procedure demonstrated high safety, adequate nodal assessment, and meaningful pathological response.