YAMAGUCHI SHIGEKI
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Non peer reviewed
Title Feasibility of the semi-opened method of specimen resection for a circumferential resection margin in rectal cancer surgery: a multicenter study.
Journal Formal name：Surgery today
Abbreviation：Surg Today
ISSN code：14362813/09411291
Domestic / ForeginForegin
Volume, Issue, Page 52(9),pp.1275-1283
Author and coauthor Takemasa Ichiro, Okuya Koichi, Okita Kenji, Ishii Masayuki, Ito Masaaki, Uehara Kay, Konishi Tsuyoshi, Yamaguchi Shigeki, Inomata Masafumi, Sugita Shintaro, Hasegawa Tadashi, Ochiai Atsushi, Sakai Yoshiharu, Watanabe Masahiko
Publication date 2022/09
Summary PURPOSE:A circumferential resection margin (CRM) > 1 mm is a surrogate marker of oncologic outcomes in rectal cancer patients. In Japan, because the mesentery is removed from the rectum, the CRM cannot be measured. This multicenter prospective study evaluates the feasibility of a resected specimen processing method that allows CRM measurement.METHODS:Fifty patients with rectal cancer were enrolled. Resected specimens were processed as previously reported. The primary outcomes were CRM measurement and the rate of CRM positivity. The secondary outcomes were the quality of total mesorectal excision, the possibility to visualize and sample the tumor, the number of harvested lymph nodes, and comparison between the pathological CRM and preoperative mesorectal fascia (MRF) involvement. This study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry under identification number UMIN000031735.RESULTS:The CRM was measurable in all patients and found to be positive in three (6%). We confirmed tumor localization, sampled the tumor, and measured the distal margin in all patients. A median of 20 lymph nodes were harvested. The concordance rate between preoperative MRF involvement and pathological CRM status was 90%.CONCLUSION:A semi-opened rectal specimen with transverse slicing is a feasible method for measuring the CRM.
DOI 10.1007/s00595-022-02481-z
PMID 35378663