Safety of Mid and Low Rectal Cancer Surgery Without Dissection of the No.253 Lymph Node (S-M-O-O-T-H)

This study examines the safety of skipping the removal of a particular set of lymph nodes (called No. 253 nodes, near the root of a major blood vessel) during surgery for mid-to-low rectal cancer, to see if this less extensive surgery has similar outcomes with fewer side effects. **You may be eligible if...** - You are between 18 and 75 years old - Your rectal cancer has been confirmed as adenocarcinoma by biopsy - The bottom of your tumor is 7 cm or less from the anus - Your tumor is at an early-to-intermediate stage (T3 or below) with no enlarged lymph nodes at the blood vessel root and fewer than 3 lymph nodes involved nearby - You are willing to have surgery **You may NOT be eligible if...** - You have had a previous malignant colorectal cancer - Your cancer is a special subtype called mucinous adenocarcinoma or signet ring cell carcinoma - Imaging shows your cancer has already spread to distant organs - You have had many prior abdominal surgeries or severe adhesions - You need emergency surgery due to obstruction, perforation, or bleeding - You have had another cancer in the past 5 years - You are in poor general health (ASA ≥IV or ECOG ≥2) - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.