Two-team lateral lymph node dissection assisted by the transanal approach for locally advanced lower rectal cancer: comparison with the conventional transabdominal approach

Narihiro, Satoshi; Kitaguchi, Daichi; Ikeda, Koji; Hasegawa, Hiro; Teramura, Koichi; Tsukada, Yuichiro; Ito, Masaaki

doi:10.1007/s00464-023-10012-1

Cited by 5 publications

(1 citation statement)

References 38 publications

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“…Transanal-assisted LLND emerges as a potentially superior surgical approach. In comparison to the traditional transabdominal approach, transanal-assisted procedures result in shorter operative times and reduced blood loss [ 56 , 57 ]. However, ongoing debate surrounds whether this approach correlates with lower postoperative complication rates and increased lateral lymph node yield.…”

Section: Surgical Treatment For Lymph Node Metastasismentioning

confidence: 99%

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer

Xiao,

Chen,

Liu

2024

World J Surg Onc

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In rectal cancer treatment, the diagnosis and management of lateral pelvic lymph nodes (LLN) are critical for preventing local recurrence. Over time, scholars have reached a consensus: when imaging suggests LLN metastasis, combining neoadjuvant chemoradiotherapy (nCRT) with selective LLN dissection (LLND) can mitigate the risk of recurrence. Selective LLND typically encompasses lymph nodes in the internal iliac and obturator regions. Recent studies emphasize distinctions between internal iliac and obturator lymph nodes regarding prognosis and treatment outcomes, prompting the need for differentiated diagnostic and treatment approaches.

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Section: Surgical Treatment For Lymph Node Metastasismentioning

confidence: 99%

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer

Xiao,

Chen,

Liu

2024

World J Surg Onc

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Comparison of the short-term surgical outcomes of lateral lymph node dissection for low rectal cancer using a robotic-assisted transabdominal approach alone or supported by a transanal approach

Tokunaga,

Kashihara,

Yoshikawa

et al. 2024

Surg Endosc

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Two-Team Transanal Total Mesorectal Excision and En Bloc Resection of the Lateral Pelvic Lymph Nodes, Main Iliac Vessels, and Pelvic Plexus for Locally Advanced Rectal Cancer With Lateral Lymph Node Metastasis

Shioi,

Ogawa,

Hosoi

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Here, we describe the precise surgical technique for a novel procedure involving 2-team transanal total mesorectal excision with en bloc lateral pelvic lymph node (LPLN) dissection combined with resection of the involved main internal iliac vessels and pelvic plexus. Methods: From September 2020 to May 2023, 4 patients underwent the procedure at our hospital. Results: The operation time and blood loss were 272 to 412 minutes and 10 to 124 mL, respectively. No patients required conversion to open surgery or exhibited Clavien-Dindo grade III or worse postoperative complications, although 2 developed grade II urinary dysfunction. All surgical margins were negative. Conclusions: Our novel 2-team method can facilitate safe and satisfactory surgery, even for highly advanced rectal cancer. The transanal approach offers excellent visibility and operability, even during LPLN and adjacent structure dissection. Furthermore, initial dissection of the distal branches of the iliac vessels prevents excessive lymphatic tissue congestion, facilitating easier, and clearer dissection.

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Two-team lateral lymph node dissection assisted by the transanal approach for locally advanced lower rectal cancer: comparison with the conventional transabdominal approach

Cited by 5 publications

References 38 publications

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer

Comparison of the short-term surgical outcomes of lateral lymph node dissection for low rectal cancer using a robotic-assisted transabdominal approach alone or supported by a transanal approach

Two-Team Transanal Total Mesorectal Excision and En Bloc Resection of the Lateral Pelvic Lymph Nodes, Main Iliac Vessels, and Pelvic Plexus for Locally Advanced Rectal Cancer With Lateral Lymph Node Metastasis

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