title: Laparoscopic lateral pelvic lymph node dissection for lower rectal cancer: initial clinical experiences with prophylactic dissection.
abstract: OBJECTIVE
  To evaluate the technical feasibility of laparoscopic lateral pelvic lymph node dissection (LPLD) following total mesorectal excision (TME) as prophylaxis for patients with advanced lower rectal cancer but no radiologic evidence of lymph node involvement.
  
  
  METHODS
  TME was performed on 30 patients with cT3N1-2M0 lower rectal cancer. LPLD was performed by laparoscopic surgery in 12 patients (LAP group),and open surgery in 18 patients (Open group). Statistical analysis was used to compare the number of harvested lymph nodes, operative time, operative blood loss, transfusion rate, and volume of transfusion between the groups.
  
  
  RESULTS
  No significant difference was observed in the number of harvested lymph nodes. Operative time was significantly longer in the LAP group; however, operative blood loss, transfusion rate, and volume of transfusion were significantly lower in the LAP group.
  
  
  CONCLUSIONS
  Laparoscopic LPLD, when performed by a well-trained laparoscopic team, is safe and feasible in some selected lower rectal cancer patients. This approach has the potential to achieve oncologic lymph node clearance equivalent to open surgical LPLD, and to overcome the cited disadvantages of LPLD, which include greater operative blood loss and urinary dysfunction.
authors.affiliation: Dept. of Surgery, Nara Medical University, Japan.
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Obara
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Koyama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueda
authors.forename: Naoto
authors.initials: N
authors.lastname: Nishigori
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.forename: Keijiro
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Hisao
authors.initials: H
authors.lastname: Fujii
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000517:prevention & control; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*