Application of extraperitoneal approach in lateral lymph node dissection for lower rectal cancer

Objective To investigate the new methods of lateral lymph node dissection for lower rectal cancer.Method After revealing the iliac blood vessels by extraperitoneal approach,the internal iliac lymph nodes,obturator lymph nodes,and relative lateral iliac artery lymph node were dissected under direct vision.Results Thoroughly lateral lymph node dissection in the 50 patients,lower segment of common iliac artery,inside and outside iliac vessels,the blood vessels and obturator nerve were completely skeletonized,with complete and clear reveal of obturator.Conclusion According to the principles of TME in low rectal cancer surgery,performing lateral lymph node dissection in extraperitoneal approach is prior to opening the abdominal cavity,pelvic autonomic nerves can be well protected,dissection can be thoroughly,also with the advantages of time-saving,non-bleeding.