J.Jpn. Surg. Soc.. 80(8): 735-747, 1979
Original article
CLINICO-PATHOLOGICAL STUDIES ON THE SATELLITE LESIONS IN THE RESECTED SPECIMENS OF RECTAL CANCERS AND DECISION ON THE EXCISIONAL LINES IN THE BOWEL INVOLVING RECTAL CANCER FROM THE VIEW POINT OF SATELLITE ADENOMAS
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First Department of Surgery, Fukushima Medical College (Director : Prof. Kenji Honda) Hiromichi Suzuki |
Results obtained were as follows:
1) The satellite lesions were detected in 45 (45%) out of 99 cases of resected specimens of rectal cancers. There were three kinds of lesions histopathologically, namely adenomas, 26 cases, metaplastic polyps, 21 cases and hyperplastic nodules, 10 cases.
2) These satellite lesions were detected more in the male than female. Adenomas were observed most frequently in the 60 decade, metaplastic polyps in the 50 decade and hyperplastic nodules in the 50 decade.
3) Several adenomas were more than 1 cm in diameter, while most of the metaplastic polyps and the hyperplastic nodules were less than 5 mm in diameter. There were pedicles in most of the adenomas and no pedicle in the metaplastic polyps or the hyperplastic nodules.
4) Most of the adenomas were located from 5.1 to 15.0 cm at the oral side from the dentate line. Metaplastic polyps were found within 10.0 cm from the dentate line.
5) Most of the adenomas were detected at the oral side of the cancerous lesion. On the other hand there were no significant differences between the oral and the anal side concerning the location of metaplastic polyps and hyperplastic nodules. Most of the adenomas and of the metaplastic polyps were positioned within 5 cm from the outer line of the cancerous lesion.
6) Most of the adenomas were detected solitary.
7) The adenomas were classified into five grades according to cellular and glandular atypia. Remarkable atypia (Grade 4 and 5) was recognized in 9 out of the total 35 lesions (26%).
8) The grade of atypia tended to be greater according to the size of the lesion and the distance from the dentate line ; that is, there was slight atypia in the lesion located less than 10 cm, moderate atypia from 10 to 15 cm and remarkable atypia more than 15 cm from the dentate line.
9) According to these results, rectal cancers must be resected at least 12 cm at the oral side and 2 cm at the anal side from the lesion.
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