Fig. 3

Laparoscopic low anterior resection for the recurrent tumor. a The root of the inferior mesenteric artery was clipped and cut (D3 lymph node dissection). b The recurrent tumor was located at the mesorectum in the presacral area. There was no intraoperative finding of invasion or adhesion to the sacrum. c Macroscopically, there were no abnormal findings on mucosa. d A pathological examination confirmed solitary lymph node metastasis (moderately differentiated adenocarcinoma) of rectal cancer