[Four Patients Who Underwent Lateral Lymph Node Dissection by an Extraperitoneal Approach for Lateral Lymph Node...

To date, the surgical approach for recurrent rectal cancer has often involved highly invasive procedures. We report our experience of 4 patients who underwent lateral lymph node dissection via an extraperitoneal approach for lateral lymph node recurrence following surgery for rectal cancer. Patient 1 was a 60-year-old woman who, 6 months after surgery, underwent surgery for lateral lymph node recurrence in 1 node. Patient 2 was a 71-year-old man who underwent surgery after colostomy for rectal cancer and 4 courses of FOLFIRI+panitumumab resulted in a PR. Five months later, he underwent left lateral lymph node dissection. Patient 3 was a 78-year-old man who underwent postoperative adjuvant chemotherapy. Ten months later he underwent colostomy closure+left lateral lymph node dissection. Patient 4 was a 66-year-old man who underwent colostomy closure+lateral lymph node dissection with concurrent resection of the right internal artery. In 3 out of 4 patients, meal intake was recommenced on day 4 after surgery, and the patients were discharged without any complications. Furthermore, 3 out of the 4 patients were recurrence-free at 19 months. We believe that our results with regards to complications and duration until meal recommencement were better than those for conventional surgery for lymph node recurrence.