Lateral pelvic lymph node dissection (LPLND) in the treatment of rectal cancer: current practice and evolving approaches in India

BackgroundThe introduction of total mesorectal excision improved locoregional control for rectal adenocarcinoma significantly. Standardisation of the technique of LPLND is lacking in literature.MethodsWe describe the current practices of case selection and technical details of lateral lymph node dissection in rectal cancer. We also describe the approach when post neo-adjuvant fibrosis renders standard resection unsafe.ResultsCareful case selection and standardisation of the lateral lymph node dissection technique is important to ensure an oncologically sound and surgically procedure . Step-by-step procedures of LPLND are described in this article, and a video is demonstrated.ConclusionsStandardisation of the techniques of lateral lymph node dissection is essential. The procedure has a definite learning curve, requiring considerable expertise to avoid complications and achieve optimal outcomes.