Miscusi G, Masoni L, Montori A
III Cattedra Patologia Speciale Chirurgica, Policlinico Umberto I, Università degli studi di Roma La Sapienza, Italy.
Surg Endosc. 1987;1(2):113-7. doi: 10.1007/BF00312697.
To define the "in vivo" lymphatic drainage from the rectum and the anal canal, 79 subjects (normal controls and patients with rectal cancer) underwent endoscopic rectal lymphoscintigraphy. This method consists of endoscopically injecting a radiolabelled colloid into the rectal and anal submucosa. The diffusion of the tracer, which is drained preferentially by the lymphatic vessels, was determined by means of a computerized gamma camera. Our results suggest a different pattern of lymphatic drainage from the rectum as compared to traditional anatomical studies. Moreover, analysis of our data yields a new hypothesis about the lymphatic spread of rectal cancer. Therefore, lymphoscintigraphy could be employed in the preoperative assessment of "N" staging of these neoplasms. This should provide better selection of patients for different surgical approaches and for adjuvant therapy. The results of 2 years of experience and possible future applications of this technique are discussed.
为明确直肠和肛管的“体内”淋巴引流情况，79名受试者（正常对照者和直肠癌患者）接受了内镜下直肠淋巴闪烁造影检查。该方法包括在内镜下将放射性标记的胶体注入直肠和肛管黏膜下层。优先通过淋巴管引流的示踪剂的扩散情况通过计算机γ相机进行测定。我们的结果表明，与传统解剖学研究相比，直肠的淋巴引流模式有所不同。此外，对我们数据的分析得出了一个关于直肠癌淋巴转移的新假说。因此，淋巴闪烁造影可用于这些肿瘤“N”分期的术前评估。这将为不同手术方式和辅助治疗的患者选择提供更好的依据。本文讨论了这项技术两年的应用经验及可能的未来应用。
