Transanal extended rectal surgery with lateral pelvic lymph node dissection

Excerpt

Lateral pelvic lymph node (LPLN) metastases are found in some patients with advanced primary rectal cancer. Although preoperative chemoradiotherapy (CRT) is current standard care for locally advanced rectal cancer, some studies have demonstrated that CRT followed by total mesorectal excision (TME) might not be sufficient [1, 2]. LPLN dissection (LPLND) for selected cases with enlarged LPLN is a treatment option and an essential surgical technique for colorectal surgeons. However, LPLN metastases usually occur at the bottom of the lateral pelvis along the internal iliac vessels. Therefore, laparoscopic LPLND is a technically complex and challenging procedure, especially in obese patients with narrow pelvises. …