WS13.399 The impact of surgical urgency on lymph node harvests in colorectal cancer resections

Background: Lymph node harvest is a key part of staging in colorectal cancer. The widely accepted standard is a minimum of 12 nodes per specimen. A higher total number of nodes has been associated with a better prognosis. It has previously been suggested that urgent or emergency colorectal cancer resections results in insufficient node harvests. The aim of this study was to compare lymph node harvests in patients undergoing elective and emergency colorectal cancer resections patients. Methods: Data were collected on patients undergoing colorectal cancer resections between April 2016-March 2018. The type of operation, urgency of surgery and lymph node yield were recorded. Results: There were 582 patients (M:F 332:250). 66 (11%) underwent surgery on an urgent or emergency basis. Fewer than 12 nodes were harvested in 39 (7.6%) of elective patients and 4 (6%) of urgent/emergency patients. The mean number of nodes harvested was 24 for planned patients and 26.5 for urgent/emergency patients. The proportion undergoing right sided resections was higher in the urgent/emergency group (53% vs 42%). Comparison of right sided resections showed a mean yield of 27.1 for planned cases and 27.7 for urgent/emergency patients. The yield was also similar for left sided resections (planned – 21.8, urgent/emergency - 25.2). Discussion: This study has shown that, in a large volume unit, lymph node harvests in patients undergoing urgent or emergency colorectal cancer resection are equivalent to those having planned surgery. This permits accurate staging and adjuvant treatment planning for those patients presenting acutely.

Citation

Gallagher, J., & Cook, T. A. (2020, December). The impact of surgical urgency on lymph node harvests in colorectal cancer resections. British Journal of Surgery. 107, pp. 134-134

DOI

10.1002/bjs.12069

URI

https://hdl.handle.net/20.500.14709/1036

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