Modified clearing technique to identify lymph node metastases in post-irradiated surgical specimens from rectal adenocarcinoma
Arch. med. res
;
27(1): 31-6, 1996. tab, ilus
Artigo
em Inglês
| LILACS
| ID: lil-200287
ABSTRACT
The aim of this study is to describe a modification of the original method of clearing lymph nodes in specimens from rectal adenocarcinoma and its yield in comparison to a control group whose specimens were studied by a manual technique. There were 32 consecutive patients with locally advanced rectal adenocarcinoma. All patients received preoperative radiation therapy (PRT) at doses of 45 Gy, concomitant with 5-fluourouracil at the doses of 450 mg/m² IV bolus, days 1-5 and 28-33 of PRT; 4-8 weeks later radical surgery with a curative intent was performed. Twenty two specimens were studied by a manual technique consisting of fixation in 10 per cent formalin. Ten specimens wer studied with the modified clearing technique consisting of administration through the inferior mesenteric artery of methylene blue; fixation with 10 per cent formalin plus 0.01 per cent of methylene blue; clearing the fat with a sequence of 95 per cent alcohol - 100 per cent acetone - 100 per cent xylene. In the 32 specimens, 413 lymph nodes were found. Using the manual technique 104 lymph nodes were found (average 4.7 lymph nodes per specimen); 309 lymph nodes by the modified clearing technique (average 30.9 lymph nodes per specimen), (p<0.0001). Using the manual technique 23 out of 104 lymph nodes (22 per cent) contained metastases. All metastatic lymph nodes measered > 5 mm; 18 out of 23 metastatic lymph nodes were located on the perirectal area (level 2); and five were located in the root of the inferior mesenteric artery (level 5). Using the modified clearing technique is a quick, easy and reproducible method for identifying lymph nodes in post-irradiated surgical specimens. In comparison to the traditional manual method of searching for lymph nodes, it improves in the detection of small lymph nodes (>5 mm), allowing better staging in patients with rectal adenocarcinoma
Buscar no Google
Índice:
LILACS (Américas)
Assunto principal:
Neoplasias Retais
/
Manejo de Espécimes
/
Procedimentos Cirúrgicos Operatórios
/
Irradiação Linfática
/
Adenocarcinoma
/
Linfonodos
/
Metástase Linfática
Tipo de estudo:
Guia de Prática Clínica
Idioma:
Inglês
Revista:
Arch. med. res
Assunto da revista:
Medicina
Ano de publicação:
1996
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS