Lateral Pelvic Lymph Node Dissection For Rectal Cancer
What are lymph nodes?
Lymph nodes are small, bean-shaped glands that host the immune cells. In the context of rectal cancer, we understand that these cancer cells can spread to lymph nodes along its major blood supply of the rectum (inferior mesenteric artery).
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Most recently, we now understand that cancer cells not only spread along the major blood supply of the rectum (inferior mesenteri artery) but also to one or both sides of the rectum; along the major blood supply of our legs despite having radiotherapy.
These locations are called external and internal iliac lymph nodes and obturator lymph nodes. These sit along the external and internal iliac arteries.
Who Should Get A Lateral Plevic Lymph Node Dissection?
Careful consideration is taken to assess:
i) location of tumour - mid to low rectal cancers are more likely to spread to the pelvic lymph nodes
ii) local staging of the primary rectal cancer - the higher the stage the more likely for spread to the pelvic lymph nodes
iii) suspicious lymph node along the inferior mesenteric artery
iv) size of the lateral pelvic lymph nodes before radiotherapy treatment - this is assessed base on a MRI scan
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All patients will need radiotherapy before surgery. Very often, another MRI scan is performed before surgery to re-assess the features of your cancer, particularly the pelvic lymph node size to determine whether surgery needs to be done to remove these.
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Picture on your right is a MRI scan showing a pelvic lymph node size of 8 mm (anything more than 5 mm is suspicious for spread of rectal cancer)
How Is The Surgery Performed?
Surgery for lateral pelvic lymph node dissection can either be performed by open or robotic surgery. It is a very delicate procedure, with harvesting of all lymph node along the major blood vessel of the pelvic organs (rectum, bladder and uterus) and legs.
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There are also an obturator nerve that supply the function of your thigh movement and pelvic nerve that supply the function of your urinary, bowel and sexual functions.
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Hence, Dr Kong will discuss with you about the delicate nature of this surgery and explain the reason to perform such a surgery to ensure you get the best cancer outcome.
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Picture on your left is an operative photo of all the important structures that were presevered after a lateral pelvic lymph node dissection
Contact Us
Dr Joseph Kong is currently consulting at
Peter MacCallum Cancer Centre (public)
Alfred Health (public)
Cabrini Hospital - Malvern (private)
Cabrini Hospital - Brighton (private)
Cabrini Specialist Centre - Hawthorn East (private)
The Avenue Hospital (private)
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Dr Joseph Kong has operating list at
Peter MacCallum Cancer Centre (public)
Alfred Health (public)
Cabrini Hospital - Malvern (private)
Cabrini Hospital - Brighton (private)
The Avenue Hospital (private)
Colorectal Consulting Group (CCG)
Specialist in Colorectal Surgery
Cabrini Hospital - Malvern
Suite 27, Cabrini Medical Centre,
Isabella Street,
Malvern 3144
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Opening Hours: 9.00 am to 5.00 pm - Monday to Friday
Email: jkongpa@ccgroup.net.au
Phone: 03 9500 2795
After hours: 03 9387 1000
Fax: 03 9576 0318