Prospective analysis of tumor spread to the small bowel mesentery in cases of right-sided colon cancer
| العنوان: | Prospective analysis of tumor spread to the small bowel mesentery in cases of right-sided colon cancer |
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| المؤلفون: | Akio Higuchi, Mamoru Uchiyama, Yasushi Rino, Takashi Oshima, Nobuhiro Sugano, Sumito Sato, Takashi Kohmura, Keisuke Kazama, Hironao Okamoto, Aya Kato, Munetaka Masuda, Manabu Shiozawa |
| المصدر: | Langenbeck's Archives of Surgery. 405:1139-1145 |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Surgical margin, medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, Metastasis, 03 medical and health sciences, Ileocecal valve, 0302 clinical medicine, Humans, Medicine, Mesentery, Colectomy, business.industry, medicine.disease, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Colonic Neoplasms, Lymph Node Excision, 030211 gastroenterology & hepatology, Surgery, Lymphadenectomy, Radiology, Neoplasm Recurrence, Local, business, Abdominal surgery |
| الوصف: | Guidelines advocate minimal ileal resection when right hemicolectomy is performed for right-sided colon cancer. The practice, thought to prevent malabsorption syndrome, does not appear to foster local recurrence. Little evidence based on rigorous study exists, however. To understand the pattern of lymphatic spread of right-sided colon cancer toward the small bowel and thus determine the appropriate margin size, we prospectively investigated anatomical distribution of lymph nodes (LNs) in the small bowel mesentery and of metastasis to these nodes in patients with right-sided colon cancer treated by such surgery. In each case, the mesenteric specimen, which had been dissected along the ileocolic vessels and included intermediate LNs, was divided into 2 areas: that 0–3 cm from the vessel pedicle (area 1) and that 3–5 cm from the pedicle (area 2). The peri-intestinal mesentery was cut into 9 segments. Ninety-one patients were included in the study. Overall, 3366 LNs were dissected. Four hundred fifty-three of these LNs were located in area 1 (90 cases), and 15 (3.3%) were metastatic. Only 63 LNs were located in area 2 (34 cases; average of 0.69 per patient); none was metastatic. Overall, 269 LNs were found in the small bowel mesentery (in 56 of the 91 patients). Only 4 were positive (3 cases), and all were within 5 cm of the ileocecal valve. Our data indicate that a surgical margin 3 cm from the ileocecal pedicle and a short (5 cm) ileal margin are oncologically reasonable for effective right hemicolectomy. |
| تدمد: | 1435-2451 1435-2443 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5e2669cebad3a23d599eb156fd9e7132Test https://doi.org/10.1007/s00423-020-02016-5Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....5e2669cebad3a23d599eb156fd9e7132 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14352451 14352443 |
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