Short-term outcomes of laparoscopic lateral dissection for lower rectal cancer

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Backgroud: In Japan, the recommended standard surgical procedure for advanced lower rectal cancer includes total mesorectal excision (TME) plus central D3 lymph node dissection and bilateral lateral lymph node dissection (LLND). Laparoscopic LLND is performed in the pelvis, which is an anatomically complex and small operative field and thus, requires an extremely high level of skill. Laparoscopic LLND has been introduced following the recent expansion in the application of laparoscopic surgery for advanced lower rectal cancer.
Patients and methods: The subject sample comprised 79 patients who underwent lateral dissection, including 61 patients who underwent laparotomic lateral dissection and 18 patients who underwent laparoscopic lateral dissection. Clinical characteristics and the oncological outcome were compared between groups.
Results: The mean surgical duration in the laparoscopy group was 285 min, which was significantly longer than the 165 min in the laparotomy group (p < 0.001). The mean blood loss amount was 131 g in the laparoscopy group, which was significantly less than the mean amount of 407 g in the laparotomy group (p < 0.001) There was no significant difference in complications.
Conclusion: The short-term outcomes of laparoscopic LLND were good, indicating that the procedure can be performed safely and is likely to be useful.