Premium
Laparoscopic total pelvic exenteration with en bloc lateral lymph node dissection after neoadjuvant chemoradiotherapy for advanced primary rectal cancer
Author(s) -
Mukai Toshiki,
Akiyoshi Takashi,
Ueno Masashi,
Fukunaga Yosuke,
Nagayama Satoshi,
Fujimoto Yoshiya,
Konishi Tsuyoshi,
Ikeda Atsushi,
Yamaguchi Toshiharu
Publication year - 2013
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12047
Subject(s) - medicine , pelvic exenteration , dissection (medical) , surgery , lymph node , colorectal cancer , prostate , chemoradiotherapy , laparoscopy , cancer , radiation therapy
Total pelvic exenteration ( TPE ) may be the only procedure that can cure T4 rectal cancer that directly invades the urinary bladder or prostate. Here, we describe our experience of laparoscopic TPE with en bloc lateral lymph node dissection for advanced primary rectal cancer. A 62‐year‐old man diagnosed with advanced lower rectal cancer ( T4bN0M0 ) underwent laparoscopic TPE with en bloc lateral lymph node dissection after neoadjuvant chemoradiotherapy. Ligation of the dorsal vein complex was performed under direct visualization through the perineal approach, and the large perineal defect was reconstructed using bilateral V ‐ Y advancement of the gluteus maximus musculocutaneous flaps. The ileal conduit was constructed extracorporeally through an extended umbilical port that was extended to 4 cm. The total operative time was 831 min and estimated blood loss was 600 mL. Laparoscopic TPE appears to be safe and feasible in selected patients.