Lateral pelvic lymph node metastasis is the main cause of the recurrence of rectal cancer, and surgery is the main treatment method. However, in terms of treatment, whether to regard lateral lymph node dissection as the standard treatment, or to treat lateral lymph node metastasis as distant metastasis with radiotherapy and chemotherapy as the main treatment method, Eastern and Western scholars hold different views. In addition, due to the complicated operation of lateral lymph node dissection, it may bring serious postoperative complications. Besides, tissue swelling and fibrosis may occur after neoadjuvant therapy, which also increase the difficulty of the operation. As a result, the deployment of the technology is limited. Therefore, controlling the occurrence of postoperative complications and evaluating the surgical indications are too important to be ignored in the development of the lateral lymph node dissection treatment strategy.