J.Jpn. Surg. Soc.. 80(12): 1520-1524, 1979

---

Report on the annual meeting

LYMPHNODES DISSECTION IN THE RADICAL OPERATION FOR CARCINOMA OF THE RECTUM

One hundred and ten patients having carcinoma of the upper and lower rectum including anal canal underwent radical surgery with extended dissection of the upward and lateral lymphatic spreads.
The tissue containing lymph nodes was obtained dissecting alongside the inferior mesenteric artery up to the origin and the internal iliac vessels including the tissue on the pelvic side wall.
All of the 3718 lymph nodes obtained were examined histologically.
The lymph node metastasis was positive in 54.5% of all cases.
The upward metastasis was present in 52.7% and the lateral matastasis was present in 17.3%, The upward metastasis was positive in almost every case with positive nodes in both direction, notwithstanding the location of the rectal lesion.
The lateral metastasis was positive most frequently in cases with low lying lesion having concomitant upward metastases.
Of the lateral nodes, the middle hemorrhoidal nodes were most frequently affected. The results substantiate the theoretical importance of the complete upward dissection in every curative operation for the rectal cancer and the necessity of the extended lateral dissection for the treatment of the low lying rectal and anal carcinoma.
(An operative technique facilitating the extended lymph nodes dissection was presented by film.)

---

---

To read the PDF file you will need Adobe Reader installed on your computer.