직장암 원위부 직장간막 내에 존재하는 전이 림프절 및 암침착: 전직장간막 절제술의 필요성
Lymph Node Metastases and Tumor Deposits in the Mesorectum Distal to Rectal Cancer: A Need of Total Mesorectal Excision
조남선, 김남규, 윤성현, 민진식, 김호근,
소속 상세정보
조남선 ( Jo Nam-Sun )
연세대학교 의과대학 외과학교실
김남규 ( Kim Nam-Kyu )
연세대학교 의과대학 외과학교실
윤성현 ( Yun Seong-Hyeun )
연세대학교 의과대학 외과학교실
민진식 ( Min Jin-Sik )
연세대학교 의과대학 외과학교실
김호근 ( Kim Ho-Keun )
연세대학교 의과대학 병리학교실
KMID : 0356719990150040273
Abstract
Purpose: Total mesorectal excision has been advocated as the effective operation for patients with rectal cancer to reduce the local recurrence rate after curative resection. Its rationale is to remove possible tumor foci at the mesorectum distal to the level of the rectal cancer. This study was undertaken to clarify the rationale for total mesorectal excision.
Methods: Total mesorectal excision was performed in 72 patients with rectal cancer who admitted in Severance Hospital between December, 1996 and December, 1997. The obtained mesorectums were classified to M0 (from the proximal margin to the distal margin of the tumor), M1 (from the distal margin to 2 cm below the distal margin), M2 (from 2 cm to 5 cm below the distal margin), and microscopic examination was done.
Results: The nodal metastases were detected in 7 cases and tumor deposits in 4 cases. Especially in M2 with Dukes’ C2, the rate of nodal metastases was 3.6 percent and the rate of tumor deposits was 7.1 percent. The nodal metastases and tumor deposits in the distal mesorectum have no correlation with gross finding, size, location and differentiation of the tumor.
Conclusion: En bloc excision of all mesorectal tissue down to at least 5 cm below the lower margin of the
tumor is required for patients with advanced rectal cancer to remove possible metastatic lymph nodes and tumor deposits in the distal mesorectum.
키워드
전직장간막 절제술
Total mesorectal excision;Mesorectum;Rectal cancer
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