Transanally assisted lateral pelvic lymph node dissection for rectal cancer

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Background:

• Lateral pelvic lymph node dissection (LLND) is crucial for rectal cancer with lymph node metastasis.
• LLND is technically challenging due to deep pelvic anatomy.
• Transanal approaches may facilitate LLND.

Purpose of the Study:

• To compare the clinical outcomes of LLND using conventional laparoscopic versus combined transanal and laparoscopic approaches.
• To evaluate the feasibility and safety of transanal-assisted LLND in rectal cancer patients.

Main Methods:

• Retrospective comparison of 39 low rectal cancer patients undergoing transanal total mesorectal excision with LLND.
• 18 patients had conventional laparoscopic LLND; 21 had combined transanal and laparoscopic LLND.
• Clinical outcomes including operative time, blood loss, and complications were analyzed.

Main Results:

• The transanal approach significantly reduced LLND operative time (54 min vs. 105 min) and intraoperative blood loss (0 g vs. 40 g).
• Postoperative complications (≥Grade II) were significantly lower in the transanal group (28.6% vs. 66.7%).
• The number of harvested lymph nodes was comparable between groups (8 vs. 8.5).

Conclusions:

• Transanal-assisted LLND is associated with reduced operative time, blood loss, and morbidity.
• This approach offers a potentially improved method for LLND in rectal cancer management.
• The transanal approach enhances the safety and efficiency of LLND.