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Appropriate treatment strategies for lateral lymph node (LN) involvement in rectal cancer are unclear and surgery remains controversial. Differences between Eastern and Western countries and the lack of strong oncologic data have led to scarce evidence regarding lateral LN dissection indications, which are not included in total mesorectal excision procedures.
Lateral recurrence is high when lateral lymph nodes are enlarged preoperatively. Neoadjuvant chemoradiotherapy can treat the lateral node compartment to prevent recurrence, but it might not be enough.
In this video, we review the indications, technique and morbidity associated with lateral LN dissection.