title: Lymph node retrieval for colorectal cancer: Estimation of the minimum resection length to achieve at least 12 lymph nodes for the pathological analysis.
abstract: BACKGROUND
  Adequate lymph node retrieval is important in colorectal cancer staging for the selection of patients that necessitate adjuvant treatments. The minimum number of 12 lymph nodes is one of the premises and is dependent, among the other factors, from the length of bowel resected. We have reviewed our specimens to identify the high-risk operations for inadequate nodal sampling and estimate the minimum length of bowel needed to resect to achieve this purpose.
  
  
  METHODS
  A retrospective review of colorectal specimens over 10 years of activity looking at data including location of the tumor, type of operation performed, length of bowel resected and number of lymph nodes retrieved.
  
  
  RESULTS
  Abdominoperineal and Hartmann's resections produced significant lower adequate retrievals compared to other colorectal operations, corresponding to 45.4% and 59.1% of cases respectively. The measured average length of bowel was 30 cm and 25 cm respectively, increasing the length to 36 cm and 42 cm would increase the adequacy rate to 90%.
  
  
  CONCLUSIONS
  Abdominoperineal and Hartmann's resections are, in our series, high-risk operations that frequently do not produce the minimum number of lymph nodes necessary. These operations may require additional maneuvers such as mobilization of the splenic flexure to achieve the minimum length of bowel to resect.
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gravante
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Rupert
authors.initials: R
authors.lastname: Parker
authors.affiliation: Department of Surgery, West Hertfordshire Hospitals, Watford, United Kingdom. Electronic address: mohamedelshaer_1@hotmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elshaer
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Adimabua Christopher
authors.initials: AC
authors.lastname: Mogekwu
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Nada
authors.initials: N
authors.lastname: Humayun
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Katie
authors.initials: K
authors.lastname: Thomas
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Rachael
authors.initials: R
authors.lastname: Thomson
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hudson
authors.affiliation: Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorge
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Katy
authors.initials: K
authors.lastname: Gardiner
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Salem
authors.initials: S
authors.lastname: Al-Hamali
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rashed
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Ashish
authors.initials: A
authors.lastname: Kelkar
authors.affiliation: Department of Surgery, Kettering General Hospital, Kettering, United Kingdom.
authors.forename: Saleem
authors.initials: S
authors.lastname: El-Rabaa
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods / Q000592:standards*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009929:Organ Size; D012189:Retrospective Studies
keywords: Abdominoperineal resection; Colorectal cancer; Hartmann resection; Lymph node; Staging