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Techniques in Coloproctology

, Volume 22, Issue 11, pp 893–894 | Cite as

Transanal extended rectal surgery with lateral pelvic lymph node dissection

  • T. Aiba
  • K. UeharaEmail author
  • T. Mukai
  • N. Hattori
  • G. Nakayama
  • M. Nagino
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Introduction

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...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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

Informed consent was obtained in accordance with the standards set forth by hospital regulations.

Supplementary material

Supplementary material 1 (WMV 196054 KB)

References

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    Kusters M, Uehara K, Velde CJHV, Moriya Y (2017) Is there any reason to still consider lateral lymph node dissection in rectal cancer? Rationale and technique. Clin Colon Rectal Surg 30:346–356.  https://doi.org/10.1055/s-0037-1606112 CrossRefPubMedPubMedCentralGoogle Scholar
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    Akiyoshi T, Ueno M, Matsueda K, Konishi T et al (2014) Selective lateral pelvic lymph node dissection in patients with advanced low rectal cancer treated with preoperative chemoradiotherapy based on pretreatment imaging. Ann Surg Oncol 21:189–196.  https://doi.org/10.1245/s10434-013-3216-y CrossRefPubMedGoogle Scholar
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    Atallah S, Albert M, Monson JR (2016) Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol 20:483–494.  https://doi.org/10.1007/s10151-016-1475-x CrossRefPubMedGoogle Scholar
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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • T. Aiba
    • 1
  • K. Uehara
    • 1
    Email author
  • T. Mukai
    • 1
  • N. Hattori
    • 2
  • G. Nakayama
    • 2
  • M. Nagino
    • 1
  1. 1.Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Gastroenterological SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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