Preoperative Factors and Middle Rectal Artery Evaluation in Lateral Lymph Node Metastasis of Lower Rectal Cancer

Study identifies preoperative factors like clinical lymph node metastasis and PET/CT status as key predictors of lateral lymph node metastasis in rectal cancer. The presence of middle rectal artery significantly correlates with pathological lymph node metastasis, particularly in the internal iliac region. Combination of clinical factors and imaging techniques shows high negative predictive value for excluding lateral lymph node dissection in select cases, offering a useful approach for treatment decision-making.