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Manual dissection of adenocarcinoma of the lower third of the rectum specimens for detection of lymph node metastases smaller than 5 mm
Author(s) -
Andreola Salvatore,
Leo Ermanno,
Belli Filiberto,
Bufalino Rosaria,
Tomasic Gorana,
Lavarino Cinzia,
Baldini Maria Teresa,
Meroni Emanuele
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960215)77:4<607::aid-cncr4>3.0.co;2-d
Subject(s) - medicine , lymph , mesorectum , rectum , lymph node , dissection (medical) , adenocarcinoma , colorectal cancer , radiology , surgery , cancer , total mesorectal excision , pathology
BACKGROUND The question of whether manual dissection when searching for metastatic lymph nodes from rectal cancer (less than 5 mm) is a reliable method remains controversial. METHODS We examined 50 consecutive cases of primary adenocarcinoma of the rectum treated with a sphincter‐sparing total rectum resection, total mesorectum excision, and coloanal anastomosis. We used a manual method for the detection of lymph nodes. RESULTS One thousand seven hundred ninety‐three lymph nodes were found (mean, 36 per patient). One hundred seventy‐four contained metastases. Seventy‐nine (45.4%) of the affected lymph nodes were less than 5 mm in greatest dimension. The percentage of metastases to small lymph nodes was similar to the percentage reported by Kotanagi (50%), but lower than the report of Herrera (78%), who used a clearing technique to search for regional lymph nodes. CONCLUSIONS A median 17 months follow‐up in these patients demonstrated that metastases in small lymph nodes are important in the accurate staging of rectal tumors and that a manual method of searching for small lymph nodes is reliable. Cancer 1996; 77:607‐12.