title: Laparoscopic total pelvic exenteration using transanal minimal invasive surgery technique with en bloc bilateral lymph node dissection for advanced rectal cancer.
abstract: A 59-year-old man presenting with fecal occult blood visited our hospital. He was diagnosed with advanced lower rectal cancer, which was contiguous with the prostate and the left seminal vesicle. There were no metastatic lesions with lymph nodes or other organs. We performed laparoscopic total pelvic exenteration (LTPE) using transanal minimal invasive surgery technique with bilateral en bloc lateral lymph node dissection for advanced primary rectal cancer after neoadjuvant chemoradiotherapy. The total operative time was 760 min, and the estimated blood loss was 200 ml. LTPE is not well established technically, but it has many advantages including good visibility of the surgical field, less blood loss, and smaller wounds. A laparoscopic approach may be an appropriate choice for treating locally advanced lower rectal cancer, which requires TPE.
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan. hayashi03149@kouseiren-ta.or.jp.
authors.forename: Kengo
authors.identifier: http://orcid.org/0000-0001-7098-1228
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kotake
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Kakiuchi
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hada
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Hiranuma
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Kaeko
authors.initials: K
authors.lastname: Oyama
authors.affiliation: Department of Surgery, Koseiren Takaoka Hospital, 5-10, Eirakucho, Takaoka, Toyama, 933-8555, Japan.
authors.forename: Takuo
authors.initials: T
authors.lastname: Hara