Transanal extended rectal surgery with lateral pelvic lymph node dissection
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.
Transanal TME (TaTME) is the latest promising approach for rectal cancer [3, 4]. Atallah et al. compared the shape of the rectum to a capital letter “L” and proposed that the horizontal portion of the rectum is the best approach from the in-line vantage point of...
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This research was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained in accordance with the standards set forth by hospital regulations.
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