Safe Distance of the Inferior Resection Line in the Rectal Carcinoma Surgery

Czech version

Authors: P. Vávra ¹; M. Rydlová ²; A. Pelikán ¹; P. Guňková ¹; L. Matínek ¹; I. Guňka ¹; M. Vávrová ³; P. Anděl ¹
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice s poliklinikou Ostrava-Poruba, přednosta doc. MUDr. J. Dostalík, CSc. ¹; Ústav patologické anatomie, Zdravotně-sociální Fakulta Ostravské Univerzity, přednosta doc. MUDr. J. Horáček, CSc. ²; Radiodiagnostický ústav FNsP Ostrava-Poruba, přednostka MUDr. S. Skotnicová ³
Published in: Rozhl. Chir., 2006, roč. 85, č. 1, s. 45-50.
Category: Monothematic special - Original

Overview

The authors present results of a study of a distal intramural spread of the rectal carcinoma beneath its aboral margin, which was conducted over several years.

The authors closely cooperated with the Pathological Anatomy Institute of the Faculty Hospital in Ostrava, where each preparation was examined not only macro- and microscopically, but also the tumor‘s microscopic spread beneath its macroscopic margin was assessed in standard distances of 2 mm, 5 mm, 1 cm, 2 cm and 5 cm.

The study did not record tumorous spread at the distance of 5 cm from the aboral margin of the tumor.

The authors also confirmed that the distal intramural spread of the tumor is fairly rare and, at the same time, it signifies a highly advanced and aggressive disorder with a poor prognosis. Therefore, the authors favor management with a maximum quantity of the sphincter- saving procedures, with a sufficiently radical mesorectal excision, which they consider the essential method of the radical surgical treatment.

Furthermore, the authors have not recorded cases of the differenciated adenocarcinoma spread, even at the distance of 2 mm from the aboral margin of the tumor. All positive findings of the distal intramural spread have been recorded in medium- low differenciated adenocarcinomas.

Key words:
carcinoma of the rectum – intramural spread of the rectal tumor – surgical management