We perform preoperative chemoradiotherapy for patients with advanced lower rectal cancer in our department. In April 2012, we started laparoscopic lateral lymph node dissection for preventive dissection in patients without lateral lymph node enlargement on preoperative diagnosis. We compared the short-term results of laparoscopic lateral dissection with those of laparotomy.
Subjects: The subjects comprised 43 patients undergoing lateral dissection by laparotomy( open group) and 5 patients undergoing laparoscopic lateral dissection (lap group).
Results: There were no significant differences in the baseline characteristics of patients between the lap group and the open group. However, operative time (min) was significantly longer( 536.2 vs 324.8) and the volume of blood loss( g) was significantly lower( 139.0 vs 697.8) in the lap group. No significant differences were observed in the number of dissected lymph nodes, postoperative complications, or the duration of hospital stay.
Conclusion: Although the operative time was longer with laparoscopy-assisted lateral lymph node dissection, this procedure was safely performed with minimal blood loss. Our findings confirmed that there were no problems with standardization of this technique or oncological outcomes, and hence, we are examining the indications for therapeutic dissection.