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Laparoscopic radical rectosigmoid cancer resection with left lateral pelvic lymph nodes dissection in a en-bloc resection manner

Wei Wang, Wenjun Xiong, Xiaofeng Zhu, Jin Wan. Guangdong Provincial Hospital of Chinese Medicine

This was a patient diagnosed with advanced rectosigmoid adenocarcinoma and was identified with enlarged lateral pelvic lymph node by computed tomography and magnetic resonance examination. The clinical TNM stage was T3N2M0 (with left lateral pelvic lymph nodes metastasis) according to the AJCC 8th Edition Cancer Staging . After discussed by multidisciplinary team, the patient received 3 course of neoadjuvant Capelox chemotherapy. The therapy effect was evaluated 2 month later and was partial response according to the new response evaluation criteria in solid tumors (Revised Recist guideline version 1.1). Finally, the patient underwent laparoscopic radical rectosigmoid cancer resection with left lateral pelvic lymph nodes dissection in a en-bloc resection manner.

Fisrtly, The left Toldt’s fascia was dissected at the level of the sacral promontory and was expanded. The inferior mesenteric artery and vein was central ligated.

Secondly, the sigmoid colon was pulled laterally. The retroperitoneum was cut to expose the ureter, common iliac artery and vein and the peripheral lymphatic tissue and fatty tissue were dissected.  

Thirdly, the sigmoid colon was pulled laterally medially. The lateralperitoneum was cut to expose the internal iliac artery and vein and external iliac artery and vein. And the peripheral lymphatic tissue and fatty tissue were dissected. The genital femoral nerve and obturator nerve were protected.

Finally, laparoscopic radical rectosigmoid cancer resection with left lateral pelvic lymph nodes dissection in a en-bloc resection manner was completed.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93877

Program Number: V081

Presentation Session: Exhibit Hall Theater Video Session III

Presentation Type: EHVideo

Post Views: 16

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