A comparison of whole-mount and conventional sections for pathological mesorectal extension and circumferential resection margin assessment after total mesorectal excision.

INTRODUCTION: The objective of the study is to compare 2 techniques for histological handling of rectal cancer specimens, namely whole-mount in a large block vs conventional sampling using small blocks, for mesorectal pathological assessment of circumferential resection margin status and depth of tumor invasion into the mesorectal fat. METHODS: This is a prospective study including 27 total mesorectal excision specimens of rectal cancer from patients treated for primary rectal carcinoma between 2020 and 2022 in a specialized multidisciplinary Colorectal Unit. For each total mesorectal excision specimen, 2 contiguous representative tumoral slices were selected and comparatively analyzed with whole-mount and small blocks macroscopic dissection techniques, enabling comparison between them in the same surgical specimen. The agreement between the 2 techniques to assess the distance of the tumor from the circumferential resection margin as well as the depth of tumor invasion was evaluated with the Student's t-test for paired samples, Pearson's correlation coefficient, and the Bland-Altman method comparison analysis. RESULTS: Complete mesorectal excision was observed in 8% of cases. Circumferential resection margin involvement was observed in only one case (4 %). The whole-mount and small block techniques obtained similar results when we assessed the distance to the circumferential resection margin (t-test P = 0.8, r = 0.92) and the depth of mesorectal infiltration (t-test P = 0.6, r = 0.95). CONCLUSIONS: Both gross dissection techniques (whole-mount vs multiple small cassettes) are equivalent and reliable to assess the distance to circumferential resection margin and the depth of mesorectal infiltration in the mesorectal fat in rectal cancer staging.

Aportes al inventario y caracterización de las plantas medicinales del pueblo originario Lenca de Intibucá, Honduras / Contributions to the inventory and characterization of the medicinal plants of the original Lenca de Intibucá people, Honduras

Se realiza una encuesta con los objetivos de identificar las plantas de uso medicinal, con el fin de efectuar un perfil socioeconómico y caracterizar el acceso a servicios de salud pública en ocho aldeas de los municipios de Intibucá, Yamaranguila y San Francisco de Opalaca, departamento de Intibucá, Honduras. Se encuestaron 76 personas en varias visitas realizadas durante el año 2014. El estudio fue exploratorio de alcance descriptivo, de muestreo no probabilístico, sujeto al criterio de pertenencia familiar al grupo étnico. Se identificaron 95 plantas con nombres comunes y que se referencian por su uso tradicional y empírico. Las cinco plantas de uso más frecuente fueron elapazote, la ruda, la manzanilla, el eucalipto y el liquidámbar, consistente con hallazgos de estudios anteriores. Sin embargo, hay siete plantas que aún no hemos identificado: la bambita, chorrito de humo, flor de cute, hierba de esencio, oreja de burro, doctorcito y el pascualillo. Las plantas medicinales son para el pueblo Lenca la primera opción de atención médica ante la pobreza extrema y el aislamiento.