The mesorectum in rectal cancer surgery—the clue to pelvic recurrence?
Tóm tắt
Five cases are described where minute foci of adenocarcinoma have been demonstrated in the mesorectum several centimetres distal to the apparent lower edge of a rectal cancer. In 2 of these there was no other evidence of lymphatic spread of the tumour. In orthodox anterior resection much of this tissue remains in the pelvis, and it is suggested that these foci might lead to suture-line or pelvic recurrence. Total excision of the mesorectum has, therefore, been carried out as a part of over 100 consecutive anterior resections. Fifty of these, which were classified as ‘curative’ or ‘conceivably curative’ operations, have now been followed for over 2 years with no pelvic or staple-line recurrence.
Từ khóa
Tài liệu tham khảo
1981, Leading Article: Colorectal surgery—the Cinderella specialty, Br. Med. J., 283
Rob, Operative surgery Vol. 4 Colon, Rectum and Anus, 3rd, 147
Heald, 1979, A new approach to rectal cancer, Br. J. Hosp. Med., 277
Talbot, 1980, The clinical significance of invasion of veins by rectal cancer, Br. J. Surg., 67, 439, 10.1002/bjs.1800670619
Blenkinsopp, 1981, Histopathology reporting in large bowel cancer, J. Clin. Path, 34, 509, 10.1136/jcp.34.5.509
Hardy, 1971, Suture-line neoplastic recurrence following large bowel resection, Aust. NZ J. Surg., 41, 44, 10.1111/j.1445-2197.1968.tb06255.x
Goligher, 1951, Local recurrence after sphincter-saving excisions for carcinoma of the rectum and rectosigmoid, Br. J. Surg., 39, 199, 10.1002/bjs.18003915504
Tyndal, 1964, Pelvic recurrence of Ca. rectum, Surg. Gynecol. Obstet., 118, 47
Morson, 1963, Pelvic recurrence after excision of the rectum for carcinoma, Br. Med. J., 2, 13, 10.1136/bmj.2.5348.13
Rosenberg, 1979, The aetiology of colonic suture-line recurrence, Ann. R. Coll. Surg. Engl., 61, 251
Williams, 1979, Distal intramural spread and local recurrence of rectal cancer, Br. J. Surg., 66, 890
Dixon, 1936, Carcinoma of the recto-sigmoid: resection without permanent colostomy, Proc. Staff Meet. Mayo Clinic, 11, 384
Gilchrist, 1959, Lymphatic spread of carcinoma of the colon, Dis. Colon Rectum, 2, 69, 10.1007/BF02616622