末段2 cm直肠癌齿状线以远浸润的临床病理研究

目的 了解末段2 cm直肠癌远端浸润的范围,为改进手术方式从而提高患者术后生活质量提供病理依据.方法 收集2005年5月至2007年7月行Miles及内括约肌切除手术(ISR)的30例直肠癌标本,于齿状线以远按0.2、0.4、0.6、0.8、1.0、1.5、2.0、2.5和3.0 cm逐段全层取材切片进行病理检查.结果 30例病例中1例标本病变位于齿状线上,下缘超过齿状线2cm.余29例齿状线以远组织病理切片结果提示均无肿瘤浸润.结论 末段2 cm直肠癌极少出现超过齿状线以远的逆行浸润,通过保留更多齿状线以远的皮肤组织很有可能减少末段2 cm直肠癌患者低位吻合保肛手术后肛门不适及其他并发症,进而可能改善这些患者术后的生活质量.

Clinicopathologic study of distal 2 cm rectal carcinoma intramural spread over dentate line

OBJECTIVE: To study the extent of distal intramural spread of distal 2 cm rectal carcinoma over the dentate line, and to improve quality of life for these patients through providing pathological evidence of operation mode choice. METHODS: Specimens of thirty patients with rectal carcinoma, operated with ISR(intersphincter resection) or Miles procedure from May 2005 to July 2007, were collected, and their large and histology pathologic slices were examined. Specimens were dissected distally to the dentate line per 2 mm within 1cm and per 5 mm exceed 1cm. The length of distal intramural spread to rectal carcinoma was measured under light microscope. RESULTS: Among the 30 specimens, distal intramural spread over the dentate line was observed only on one case and the invasion length over the dentate line was more than 2 cm, the invasion lengths of the other 29 cases were within the dentate lines. CONCLUSION: Distal 2 cm rectal carcinomas seldom spread over dentate lines. Anus discomfortableness of these patients and other complications could be reduced through reserving more skin over the dentate line, which are important for the improving of quality of life in these patient.