Laparoscopic lateral pelvic lymph node dissection for patients with low rectal cancer

Local recurrence could be decreased and Survival could be improved in patients with cT3 or N+ mid-low rectal cancer by lateral lymph node resection. By using 5-ports method, the surgical procedures could be performed following 3 space dissection principle, firstly total mesorectum excision, then dissection of lymph node between superior hypogastric plexus/hypogastric nerve and common/internal iliac arteries with preservation of autonerve, and last lymph node in the obturator formamen.A selective one side or two sides lateral lymph node dissection should be performed according to the circumferential location of the tumor, depths of tumor invasion and lateral lymph node status. Laparoscopic lateral lymph node dissection bears the benefit of magnified view, and easier manipulation in the narrow space especially in the obturator foramen, which is also a safe and effective procedure. Key words: Rectal neoplasms; Laparoscopy; Lymph node excision