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Measurement of distal intramural spread and the optimal distal resection by naked eyes after neoadjuvant radiation for rectal cancers.
Sun, Ge; Ye, Xiaolong; Zheng, Kuo; Zhang, Hang; Broens, Paul; Trzpis, Monika; Lou, Zheng; Gao, Xianhua; Liu, Lianjie; Hao, Liqiang; Furnee, Edgar; Bai, Chenguang; Zhang, Wei.
Afiliação
  • Sun G; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Ye X; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
  • Zheng K; Department of Pathology, Changhai Hospital, Shanghai, China.
  • Zhang H; Institute of Pathology, Southwest Hospital, Chongqing, China.
  • Broens P; Key Laboratory of Tumor Immunopathology, Ministry of Education of China, Chongqing, China.
  • Trzpis M; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Lou Z; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Gao X; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
  • Liu L; Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
  • Hao L; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Furnee E; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Bai C; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Zhang W; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
World J Surg Oncol ; 20(1): 296, 2022 Sep 14.
Article em En | MEDLINE | ID: mdl-36104818
BACKGROUND: The safe distance between the intraoperative resection line and the visible margin of the distal rectal tumor after preoperative radiotherapy is unclear. We aimed to investigate the furthest tumor intramural spread distance in fresh tissue to determine a safe distal intraoperative resection margin length. METHODS: Twenty rectal cancer specimens were collected after preoperative radiotherapy. Tumor intramural spread distances were defined as the distance between the tumor's visible and microscopic margins. Visible tumor margins in fresh specimens were identified during the operation and were labeled with 5 - 0 sutures under the naked eye at the distal 5, 6, and 7 o'clock directions of visible margins immediately after removal of the tumor. After fixation with formalin, the sutures were injected with nanocarbon particles. Longitudinal tissues were collected along three labels and stained with hematoxylin and eosin. The spread distance after formalin fixation was measured between the furthest intramural spread of tumor cells and the nanocarbon under a microscope. A positive intramural spread distance indicated that the furthest tumor cell was distal to the nanocarbon, and a negative value indicated that the tumor cell was proximal to the nanocarbon. The tumor intramural spread distance in fresh tissue during the operation was 1.75 times the tumor intramural spread distance after formalin fixation according to the literature. RESULTS: At the distal 5, 6, and 7 o'clock direction, seven (35%), five (25%), and six (30%) patients, respectively, had distal tumor cell intramural spread distance > 0 mm. The mean and 95% confidence interval of tumor cell intramural spread distance in fresh tissue during operation was - 0.3 (95%CI - 4.0 ~ 3.4) mm, - 0.9 (95%CI - 3.4 ~ 1.7) mm, and - 0.4 (95%CI - 3.5 ~ 2.8) mm, respectively. The maximal intraoperative intramural spread distances in fresh tissue were 8.8, 7, and 7 mm, respectively. CONCLUSIONS: The intraoperative distance between the distal resection line and the visible margin of the rectal tumor after radiotherapy should not be less than 1 cm to ensure oncological safety.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Terapia Neoadjuvante Limite: Humans Idioma: En Revista: World J Surg Oncol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: China País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Terapia Neoadjuvante Limite: Humans Idioma: En Revista: World J Surg Oncol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: China País de publicação: Reino Unido