Görög Dénes, Nagy Péter, Péter Antal, Perner Ferenc
Department of Transplantation and Surgery, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Pathol Oncol Res. 2003;9(3):180-3. doi: 10.1007/BF03033734. Epub 2003 Oct 7.
Careful lymph node dissection from colorectal resection specimens is important procedure for cancer staging. Present study intended to assess the impact of surgical technique and patient's obesity on this process. Number of lymph nodes harvested by manual dissection from resection specimens of 141 patients with rectal cancer and the rate of nodal metastases were analyzed and compared in different groups of patients selected by length of resection specimen and body mass index. The median and mean number of lymph nodes found per patient were 6 and 6.7. The shorter resection specimens (<16 cm after formalin fixation) yielded significantly lower number of nodes than those with length > 16 cm (5.7 versus 7.9). Most significant reduction in mean number of lymph nodes was observed in obese patients with short specimens (4.8). This subset of patients presented the lowest rate of nodal metastases (38%). The surgical technique seems to be an important factor for lymph node recovery from rectal resections specimens. The patient's obesity had an unfavourable impact on this procedure. Standardized surgery and histopathological examination are needed even in non-specialized centers to harvest adequate number of lymph nodes.
对结直肠切除标本进行仔细的淋巴结清扫是癌症分期的重要步骤。本研究旨在评估手术技术和患者肥胖对这一过程的影响。对141例直肠癌患者切除标本进行手动清扫所获取的淋巴结数量以及不同切除标本长度和体重指数分组患者的淋巴结转移率进行了分析和比较。每位患者发现的淋巴结中位数和平均数分别为6个和6.7个。较短的切除标本（福尔马林固定后<16 cm）所获得的淋巴结数量明显低于长度>16 cm的标本（5.7个对7.9个）。在标本短的肥胖患者中观察到平均淋巴结数量减少最为显著（4.8个）。这一亚组患者的淋巴结转移率最低（38%）。手术技术似乎是影响从直肠切除标本中获取淋巴结的一个重要因素。患者肥胖对这一操作有不利影响。即使在非专科中心，也需要标准化的手术和组织病理学检查以获取足够数量的淋巴结。
