Abstract:

Abstract:Objective To investigate the metastatic pattern of lymph node around rectum in theextensive radical mastectomy   of rectal carcinoma protecting  pelvic splanchnic nerve, and explore  the significance of lateral lymphnode  clearance in rectal carcinoma. Methods 114 rectal carcinoma patients were treate with  extensive radical mastectomy for rectal carcinoma  protecting  pelvic splanchnic nerve. The lymph nodes were cleared and observed by  conventional pathological method (hematoxylin and eosin staining), and  the metastatic pattern of lymph nodes around rectum was analyzed. Results Among 114 patients, 46 patients had metastasis in lymph nodes, the total metastatic rate was 40.4%(46/114). The metastatic rates of mesenteric lymph nodes, lymph nodes around inferior mesenteric artery and lateral lymph nodes were 39.5%(45/114), 3.9%(2/51), and 19.6%(11/114), respectively. Total 2 463 lymph nodes were cleared and 209 lymph nodes were  metastasized,the total metastatic extent was 8.5%(209/2 463). The metastatic extent for absorbent gland of mesenteric lymph nodes, lymph nodes around inferior mesenteric artery and lateral lymph nodes  were 14.8%(187/1 264), 1.7%3/175), and 1.9%(19/1 024). The metastatic extent for absorbent gland and metastatic rate  of  mesenteric lymph nodes were higher than  those of lymph nodes around inferior mesenteric artery and lateral lymph nodes（P<0.05）. The metastatic rate and extent of mesenteric lymph nodes were related to the  Duke’s stage and the infiltration  extent（P<0.05）. And the matastatic rate and extent of lymph nodes of lateral lymph nodes were related to the Duke’s stage and differentiation extent（P<0.05）. Conclusion The slective  extensive radical mastectomy for rectal carcinoma is feasible .

Key words: rectal carcinoma, lateral lymph node, mesenteric lymph nodes, metastasis