Canine apocrine gland anal sac adenocarcinoma (AGASACA) is a locoregionally aggressive tumor that frequently metastasizes to the iliosacral lymph nodes. Surgical treatment is typically considered the first line treatment for most primary anal sac tumors. In patients undergoing iliosacral lymph node extirpation the incidence of surgical complication such as hemorrhage is up to 18%, and mortality rate is up to 2.2%. The risk of complication associated with iliosacral lymph node extirpation was higher if lymph node size was >4.5cm compared with <4.5cm.