[Study on retrograde metastasis rule of middle-low rectal cancer].
OBJECTIVE
To investigate the resection range of mesorectum and rectum below the inferior margin of tumor for the total mesorectum excision (TME) in middle-low rectal cancer.


METHODS
Sixty patients were enrolled in the study. After TME operation, serial 5 mm interval sections were made in specimens of middle-low rectal cancer. The retrograde metastasis of rectal cancer was observed by routine HE staining.


RESULTS
The phenomena of retrograde metastasis in mesorectum were found in 15 cases, and the distance of retrograde metastasis was 0.5-4.0(2.47+/-1.06) cm, which was correlated with Dukes stage, lymph node metastasis and histological differentiation. The retrograde metastases in bowel were found in 11 cases, and the distance of retrograde metastasis was 0.5-4.0 (1.64+/-1.16) cm, which was correlated with histological differentiation.


CONCLUSIONS
The distal mesorectum should be resected at least 4 cm when TME is carried out, and the distal bowel at least 2.5 cm. More than 5 cm mesorectum and bowel should be resected when advanced Dukes stage, extensive lymph node metastasis and poor histological differentiation occurred.
Wang
Xi-Shan
XS
Department of Surgery, Affiliated Hospital, Harbin Medical University, Harbin 150040, China. wxshan1208@yahoo.com.cn
Jiang
Shi-Xiong
SX
Shi
Qing-Tao
QT
Zhao
Xu-Hai
XH
Wang
Yi-Hui
YH
Wang
Yan-Ying
YY
Li
Chun-Mei
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology*; D012007:Rectum / Q000473:pathology*