Rectal cancer is one of the most common malignant tumors, with 9% to 23% of patients
experiencing pelvic sidewall lymph node metastasis. According to the current Chinese
guidelines for diagnosing and treating colorectal cancer, pelvic sidewall lymph node
dissection is recommended for patients who have experienced or are suspected of having
lateral lymph node metastasis. Lateral lymph node dissection can result in longer operation
times, increased bleeding, and complications such as urinary and sexual dysfunction after
surgery. Currently, the presence of metastasis is primarily determined by the size and
enhancement characteristics of lateral lymph nodes observed through imaging studies. However,
the pathological lymph node metastasis rate of specimens collected after lateral lymph node
dissection based on current imaging criteria is only 20.5%. Therefore, a pressing clinical
challenge is accurately determining the presence of lateral lymph node metastasis and
avoiding unnecessary lateral lymph node dissection in patients who have not experienced
lateral lymph node metastasis.
Sentinel lymph node biopsy has been widely used in clinical practice. It has replaced
traditional lymph node dissection in some breast cancer and melanoma patients, reducing
surgical risks and complications and improving patients' quality of life. This study aims to
use indocyanine green as a tracer for fluorescence-guided laparoscopic navigation to locate
the lateral sentinel lymph nodes of rectal cancer in the pelvic cavity. By studying the
accuracy, specificity, and false-negative rate of predicting lateral lymph node status using
the sentinel lymph node, we can further clarify the clinical significance of the lateral
sentinel lymph node.