作者：中国医师协会内镜医师分会腹腔镜外科专业委员会，中国医师协会结直肠肿瘤专业委员会腹腔镜专业委员会，中华医学会外科学分会结直肠外科学组，中国抗癌协会结直肠肿瘤整合康复专业委员会，中国医疗保健国际交流促进会结直肠病分会

Authors: Laparoscopic Surgery Committee of the Endoscopist Branch in the Chinese Medical Doctor Association (CMDA), Laparoscopic Surgery Committee of Colorectal Cancer Committee of Chinese Medical Doctor Association (CMDA), Colorectal Surgery Group of the Surgery Branch in the Chinese Medical Association (CMA), Chinese Anti -Cancer Association Colorectal Tumor Integrated Rehabilitation Committee, China International Exchange and Promotive Association for Medical and Health Care Colorectal Disease Branch

摘要：

侧方淋巴结是中低位直肠癌常见的转移部位，亦是术后局部复发的主要原因。目前国际上针对直肠癌侧方转移的诊断、治疗尚存争议。本共识在《中国直肠癌侧方淋巴结转移诊疗专家共识（2019版）》的基础上，结合国内外最新研究成果，国内42位结直肠癌研究领域的专家针对直肠癌侧方淋巴结转移的诊断、治疗策略、随诊以及复发处理4个方面进行修订，提出18条侧方淋巴结诊疗相关共识，并采用美国预防医学工作组的评价标准进行等级推荐，旨在进一步规范直肠癌侧方淋巴结转移的诊断标准及治疗策略。在本共识中未解决的相关问题，尚需进一步临床实践，并积极开展高质量的临床研究逐步探索和解决。

关键词：直肠肿瘤，中低位；侧方淋巴结转移；侧方淋巴结清扫；新辅助治疗；专家共识

Abstract：

Lateral lymph node metastasis (LLNM) is common in mid -low rectal cancer and is also a major cause of postoperative local recurrence. Currently, there is still controversy regarding the diagnosis and treatment of LLNM in rectal cancer. This consensus, based on the“Chinese Consensus on Diagnosis and Treatment of Lateral Lymph Node Metastasis in Rectal Cancer (2019 edition) ” , incorporates the latest domestic and international research findings and revises aspects related to the diagnosis, treatment strategies, follow-up, and management of recurrence of LLNM in rectal cancer. A total of 42 domestic colorectal cancer experts participated in this consensus. It proposes 18 consensus statements on the diagnosis and treatment of LLNM, using the evaluation criteria of the U.S. Preventive Services Task Force for grading recommendations. The aim is to standardize further the diagnostic criteria and treatment strategies for LLNM in rectal cancer. Unresolved issues in this consensus require further clinical practice and active engagement in high-quality clinical research to explore and address them progressively.

Key Words:  Rectal neoplasms, mid-low; Lateral lymph node metastasis; Lateral lymph node dissection; Neoadjuvant chemoradiotherapy; Expert consensus

利益申明：本文首次发表在《中华胃肠外科杂志》2024 年第27 卷第1 期，第1-14 页。DOI：10.3760/cma.j.cn441530-20231212-00211。征得《中华胃肠外科杂志》同意后在本刊二次发表。