Rescue Surgery in Low Rectal Cancer With Recurrence in Pelvic and Inguinal Lymph Nodes, Both Via Minimally Invasive Approach
Year: 2024
Type: article
Study design: Case Report
Abstract: Introduction Low rectal cancer is a challenging condition, particularly when a patient experiences recurrence after neoadjuvant treatment and initial surgery. This video presents a case of low rectal cancer with recurrence in pelvic and inguinal lymph nodes, and describes the minimally invasive surgical approach for pelvic lateral lymphadenectomy and also for inguinal lymphadenectomy. Objectives To demonstrate the technique and outcomes of both pelvic lateral and inguinal lymphadenectomy via minimally invasive approach in a patient with recurrence of low rectal cancer. Methods A 68-year-old male patient, diagnosed with adenocarcinoma of the low rectum, underwent neoadjuvant chemotherapy and radiotherapy followed by abdominoperineal amputation of the rectum. Subsequently, he developed recurrence in the right lateral pelvic and right inguinal lymph nodes. A rescue surgery was performed with right pelvic lateral lymphadenectomy via videolaparoscopy and right inguinal lymphadenectomy via minimally invasive approach, an innovative technique for performing this lymphadenectomy. Results The video demonstrates the detailed surgical technique for both pelvic lateral and inguinal lymphadenectomy, including how to perform inguinal lymphadenectomy via minimally invasive approach, patient positioning, anatomical marking, dissection, and removal of affected lymph nodes. The surgery was successful, with complete removal of the recurrent lymph nodes and no significant post-operative complications. The minimally invasive approach proved effective in reducing hospitalization time and promoting post-operative recovery. Conclusion Minimally invasive pelvic lateral and inguinal lymphadenectomy is an effective and safe approach for patients with recurrence of low rectal cancer in pelvic and inguinal lymph nodes. This video illustrates the surgical techniques and benefits of this approach in the management of nodal recurrences. Publication History Article published online: 25 April 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
Source: Journal of Coloproctology
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409791984