지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2010.5
- 수록면
- 298 - 304 (7page)
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Purpose: Total mesorectal excision (TME) has been widely accepted as the principal method in rectal cancer surgery and demonstrates good oncologic and functional outcome. The recurrence rate of mid-low rectal cancer surgery with TME is reported as 5∼6%. Concerning local recurrence, remaining microscopic nodules in mesorectum are a major issue. In this study, we investigated mesorectal spread of tumors and exact lateral resection margin using whole mount section (WMS) to obtain correlations with other clinico-pathological variables.
Methods: 63 rectal cancer patients underwent surgery with TME and WMS at National Health Insurance Corporation Ilsan Hospital between December 2005 and October 2008. Preoperative study was made by computed tomography (CT), magnetic resonance imaging (MRI). We measured the distance from the largest cut section of the primary tumor to the nearest circumferential margin using MRI and compared them to lateral resection margins in WMS.
Results: Among 63 patients, the sex ratio was 1：1.17 and the median age was 62.7 years. There were 34 patients in TNM stage Ⅲ (54.0%), 21 patients in stage Ⅱ (33.3%) and 8 patients in stage Ⅰ (12.7%). Lateral margin involvement was predicted in 4 cases pre-operatively and confirmed in 3 cases with WMS. Micrometastasis in mesorectum was detected in 6 patients (9.5%) and all were in stage Ⅲ. N stage was statistically correlated with micrometastasis (P=0.016).
Conclusion: WMS offers precise lateral resection margin and mesorectal spread of microscopic tumor nodules. WMS is best considered in stage Ⅲ cancer to evaluate mesorectal micrometastasis. The mid-low rectal cancer cases with predicted lateral margin involvements using MRI should be operated on with great care.
Methods: 63 rectal cancer patients underwent surgery with TME and WMS at National Health Insurance Corporation Ilsan Hospital between December 2005 and October 2008. Preoperative study was made by computed tomography (CT), magnetic resonance imaging (MRI). We measured the distance from the largest cut section of the primary tumor to the nearest circumferential margin using MRI and compared them to lateral resection margins in WMS.
Results: Among 63 patients, the sex ratio was 1：1.17 and the median age was 62.7 years. There were 34 patients in TNM stage Ⅲ (54.0%), 21 patients in stage Ⅱ (33.3%) and 8 patients in stage Ⅰ (12.7%). Lateral margin involvement was predicted in 4 cases pre-operatively and confirmed in 3 cases with WMS. Micrometastasis in mesorectum was detected in 6 patients (9.5%) and all were in stage Ⅲ. N stage was statistically correlated with micrometastasis (P=0.016).
Conclusion: WMS offers precise lateral resection margin and mesorectal spread of microscopic tumor nodules. WMS is best considered in stage Ⅲ cancer to evaluate mesorectal micrometastasis. The mid-low rectal cancer cases with predicted lateral margin involvements using MRI should be operated on with great care.
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결론
REFERENCES
참고문헌 (29)
참고문헌 신청
1. [학술지(정기간행물)] - Reynolds JV / 1996 / Pathological evidence in support of total mesorectal excision in the management of rectal cancer / Br J Surg 83 : 1112 ~ 1115
2. [학술지(정기간행물)] - Soreide O / 1997 / Local recurrence after operative treatment of rectal carcinoma: a strategy for change / J Am Coll Surg 184 : 84 ~ 92
3. [학술지(정기간행물)] - Heald RJ / 1982 / The mesorectum in rectal cancer surgery--the clue to pelvic recurrence? / Br J Surg 69 : 613 ~ 616
4. [학술지(정기간행물)] - Heald RJ / 1986 / Recurrence and survival after total mesorectal excision for rectal cancer / Lancet 1 : 1479 ~ 1482
5. [학술지(정기간행물)] - Lee KY / 2001 / Pattern of recurrence after curative resection for rectal cancer / J Korean Surg Soc 61 : 588 ~ 592
2. [학술지(정기간행물)] - Soreide O / 1997 / Local recurrence after operative treatment of rectal carcinoma: a strategy for change / J Am Coll Surg 184 : 84 ~ 92
3. [학술지(정기간행물)] - Heald RJ / 1982 / The mesorectum in rectal cancer surgery--the clue to pelvic recurrence? / Br J Surg 69 : 613 ~ 616
4. [학술지(정기간행물)] - Heald RJ / 1986 / Recurrence and survival after total mesorectal excision for rectal cancer / Lancet 1 : 1479 ~ 1482
5. [학술지(정기간행물)] - Lee KY / 2001 / Pattern of recurrence after curative resection for rectal cancer / J Korean Surg Soc 61 : 588 ~ 592
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UCI(KEPA) : I410-ECN-0101-2013-514-002678211