Lateral pelvic lymphadenectomy in rectal cancer. Initial experience in a Public Hospital in Chile

Abstract

Introduction: Local recurrence after treatment of rectal cancer (RC) has decreased from 40% to 4-10% thanks to total mesorectal excision and neoadjuvant therapy. Between 7% and 25% of patients may have neoplastic involvement in the lymph nodes of the lateral pelvic compartments, contributing to local recurrence. Surgical technique of lateral pelvic lymphadenectomy (LPL) aims to resect these lymph nodes.

The main objective of this study is to evaluate the perioperative results of the implemen-tation of this technique in a Public Hospital.

Material and Methods: A concurrent cohort study was conducted that included patients with RC undergoing LPL with curative intent. The primary objective is to evaluate perioperative morbidity, and the secondary objective is to evaluate pathological results. Demographic, preoperative, postoperative and oncological variables were analyzed using descriptive statistics.

Results: 5 LPLs were performed. Average age was 56 years. Four patients had suspected obturator involvement and 1 internal iliac. Surgical approach was laparoscopic in 4 cases, with 1 con-version due to bleeding. The average LPL time was 117 min. Two patients had metastatic lymph nodes. There was 1 reoperation for anastomotic leak. No serious nerve injuries or need for permanent urinary catheter were recorded.

Conclusion: Our series shows that the implementation of LPL is feasible for an experienced surgical team.