Diagnostic evaluation of angiography for rectal cancer - From the aspect of anatomical structures.

概要

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The aim of this study was to evaluate the preoperative efficacy of arteriography in determining the extent of the field of dissection of lymphatics in surgery for rectal cancer. The studied angiograms were 52 postoperative microarteriograms and 233 preoperative inferior mesenteric arteriograms. The results were as follows ; 1) It was possible to diagnose the horizontal spread of cancers by differentiating the first branches of the superior rectal arteries and by interpreting the direct findings of tumor feeding arteries and circumferential indirect findings. 2) A close corelation was found between the extramural local spread of the tumor (S-max) and the extramural length of visualized arterial abnormalities (L-max). An L-max value of less than 10 mm was found to indicate no invasion to adjacent organs, more than we should counter to be with invasions. 3) The relationships between middle rectal arteries (MRA) and the main tumors were classified into four categories. Applying this categorization, there was a high incidence of metastasis to the lateral lymph nodes if the tumors were fed from the MRA, wheseas in contrast, there were no cases of metastasis if the MRA were distant from the main tumor and not involved with feeding.
日本大腸肛門病学会の論文