直肠癌经肛旁侧盆腔淋巴结清扫（TaLPLND）的疗效和安全性尚未明确。本研究旨在评估TaLPLND的短期结果作为初步体验。此回顾性研究收纳了2018年7月至2021年7月间进行TaLPLND的中下段直肠癌患者。我们的机构针对盆腔旁淋巴结清扫（LPLND）的区域包括髂内区域和闭孔区域。共分析了30位连续病例。中位数年龄为60岁（36-83岁），男女比例为2：1。中位数手术时间为362分钟（IQR，283-661分钟），中位数围手术期失血量为74毫升（IQR，5-500毫升）。有1例病例需要围手术期输血，未发生改行开腹手术的病例。13位患者（43.3％）双侧进行TaLPLND，5例患者（16.7％）进行了结合内髂血管切除的LPLND。肛缘远端切缘的中位距离为20毫米。1例病例的病理放射性切缘（pRM）为阳性，阴性pRM率为96.7％。术后短期并发症（Clavien-Dindo分类≥II级）在9例中观察到（30.0％）。未发生再手术或死亡病例。淋巴结清扫数量的中位数为11个（3-28个）。病理检查中，7例（23.3％）盆腔旁淋巴结为转移。从肿瘤的淋巴引流的上游来看，TaLPLND看起来是有益的。这一初步经验的短期结果表明这种新方法是可行的。 © 2023 Springer Nature Switzerland AG。

The efficacy and safety of transanal lateral pelvic lymph node dissection (TaLPLND) in rectal cancer has not yet been clarified. The aim of the present study was to evaluate the short-term results as an initial experience of TaLPLND.This retrospective study included patients with middle to lower rectal cancer who underwent TaLPLND from July 2018 to July 2021. Our institutions targeted lymph nodes in the internal iliac area and the obturator area for lateral pelvic lymph node dissection (LPLND).A total of 30 consecutive patients with rectal cancer were included in this analysis. The median age was 60 years (range, 36-83 years), and the male-female ratio was 2:1. The median operative time was 362 min (IQR, 283-661 min), and the median intraoperative blood loss was 74 ml (IQR, 5-500 ml). Intraoperative blood transfusion was required in one case. No cases required conversion to laparotomy. TaLPLND was performed bilaterally in 13 patients (43.3%). Five patients (16.7%) underwent LPLND with combined resection of the internal iliac vessels. The median distance of the distal margin from the anal verge was 20 mm. The pathological radial margin (pRM) was positive in one case, and the negative pRM rate was 96.7%. Short-term postoperative complications (Clavien-Dindo classification grade ≥ II) were observed in nine cases (30.0%). There were no cases of reoperation or mortality. The median number of harvested lateral pelvic lymph nodes was 11 (range, 3-28). On pathological examination, lateral pelvic lymph nodes were positive for metastasis in seven cases (23.3%).TaLPLND appeared to be beneficial from an oncological point of view because it was close to the upstream lymphatic drainage from the tumor. The short-term outcomes of this initial experience indicate that this novel approach is feasible.© 2023. Springer Nature Switzerland AG.