摘要
目的研究直肠癌远端肠壁内浸润情况,为直肠癌手术提供依据。方法将60例直肠癌根治手术标本整体平铺用溶脂法处理后,从肿瘤下极开始每隔0.5cm切取肠壁一块,显微镜下观察肿瘤远端肠壁浸润情况。结果60例标本中有11例发现肿瘤向远端正常肠壁浸润,浸润阳性率为18.3%。其中浸润≤0.5cm者5例,>0.5cm而≤1.0cm者2例,>1.0cm而≤1.5cm者4例。浸润距离最远者为1.5cm共2例。直肠癌远端肠壁浸润与肿瘤的大体类型、组织学类型和浸润深度有关(P<0.05),与性别、年龄、肿瘤部位、大小、有无淋巴结转移以及Dukes分期无关。结论直肠癌远端肠壁浸润最远距离为1.5cm,根治手术时肿瘤远端肠壁切除不应少于1.5cm,对于癌肿分化差、浸润较深的病例,术中更应严格遵循切除范围。
Objective To study the distal intramural spread of rectal carcinoma, and provide evidence for modification of rectal carcinoma surgery. Methods Sixty patients with rectal carcinoma admitted to the first affiliated hospital of Chongqing university of medical science from November 2001 to October 2002 were included. The specimens were extended to its original size and shape by the fat clearing method. Mesenteric lymph nodes were dissected by using transillumination to examine metastases histologically, then a lymph nodes map was produced which including the site of the primary lesion, the vascular distribution, and the sites of dissected nodes. The specimen below the distal margin of the tumor was cut continuously with 0.5 cm interval then sectioned for histopathological examination. Results Tumor spread to the distal intramural was observed in 11 of 60 patients （18. 3%） with the range within 1.5 cm, of which less than 0.5 cm in 5 case, 5 cm to 1.0 cm in 2 cases, 1.0 cm to 1.5 cm in 4 cases. The tumor invasion was correlated with gross type, histological type and infiltrative depth, but not with sex, age, location of the tumor, size of the tumor, lymph nodes metastases and Dukes stage. Conclusion The range of distal mural excision should exceed 1.5 cm to tumor margin in radical surgery for rectal carcinoma. This rule should be emphasized for patients with poor cell differentiation and deep infiltration.
出处
《中国普外基础与临床杂志》
CAS
2006年第1期94-96,105,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
直肠肿瘤
远端壁内扩散
手术
Rectal neoplasm Distal intramural spread Operation
