The choice of an endoscopie resection or a surgical resection based on the surgical cases of early rectal cancer

Toshihito Sawada, Takeshi Hayakawa, Takehiko Dohi, Masaki Ueno, Yoshihiro Kinoshita, Kenji Tsutsumi, Masamichi Matsuda, Yoshiaki Kajiyama, Masashi Hashimoto, Harusi Udagawa, Goro Watanabe, Masahiko Tsurumaru

Research output: Contribution to journalArticle

Abstract

Preserving defection, urination and sexual functions while maintaining radicality is a point which must be considered in choosing endoscopic versus surgical resection in early rectal cancer. The exact diagnosis of the depth of invasion is the msot important point in selecting the appropriate treatment. Detecting vascular invasion is essential determining whether minimally invasive, reduction surgery is feasible. The ratio of lymph node metastasis in early rectal cancer was 4.8% in sml cases and 19.3% in sm2,3 cases. When we divided the cases into vascular invasion ( -) and vascular invasion (+) groups, there was a significant difference between the ratios of lymph node metastasis (the former-0.0% and the later2.6%). In order to avoid rectal amputation for lesions of the lower part of the rectum (P and Rb near by P), treatment selection should be based strictly and precisely on determination of the depth of invasion and the existence of vascular invasion as revealed in samples obtained by endoscopic or local resection. The ratio of lymph node metastasis was extremely low in sm2,3 cases without vascular invasion, and in sml cases. Therefore, endoscopic or local resection is feasible in most of these cases, such that rectal amputation can be avoided. In cases requiring extensive and lymph node dissection, D1 lymph node dissection (upper side D2 and lateral side D1) is preferred over D2 or D3 dissection, because all cases with lymph node metastasis were n1(+). We consider this to be the only treatment which guarantees full preservation of autonomic function.

Original languageEnglish (US)
Pages (from-to)930-935
Number of pages6
JournalJapanese Journal of Gastroenterological Surgery
Volume30
Issue number4
DOIs
StatePublished - Jan 1 1997

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Rectal Neoplasms
Blood Vessels
Lymph Nodes
Neoplasm Metastasis
Lymph Node Excision
Amputation
Minimally Invasive Surgical Procedures
Urination
Rectum
Dissection
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Sawada, Toshihito ; Hayakawa, Takeshi ; Dohi, Takehiko ; Ueno, Masaki ; Kinoshita, Yoshihiro ; Tsutsumi, Kenji ; Matsuda, Masamichi ; Kajiyama, Yoshiaki ; Hashimoto, Masashi ; Udagawa, Harusi ; Watanabe, Goro ; Tsurumaru, Masahiko. / The choice of an endoscopie resection or a surgical resection based on the surgical cases of early rectal cancer. In: Japanese Journal of Gastroenterological Surgery. 1997 ; Vol. 30, No. 4. pp. 930-935.
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abstract = "Preserving defection, urination and sexual functions while maintaining radicality is a point which must be considered in choosing endoscopic versus surgical resection in early rectal cancer. The exact diagnosis of the depth of invasion is the msot important point in selecting the appropriate treatment. Detecting vascular invasion is essential determining whether minimally invasive, reduction surgery is feasible. The ratio of lymph node metastasis in early rectal cancer was 4.8{\%} in sml cases and 19.3{\%} in sm2,3 cases. When we divided the cases into vascular invasion ( -) and vascular invasion (+) groups, there was a significant difference between the ratios of lymph node metastasis (the former-0.0{\%} and the later2.6{\%}). In order to avoid rectal amputation for lesions of the lower part of the rectum (P and Rb near by P), treatment selection should be based strictly and precisely on determination of the depth of invasion and the existence of vascular invasion as revealed in samples obtained by endoscopic or local resection. The ratio of lymph node metastasis was extremely low in sm2,3 cases without vascular invasion, and in sml cases. Therefore, endoscopic or local resection is feasible in most of these cases, such that rectal amputation can be avoided. In cases requiring extensive and lymph node dissection, D1 lymph node dissection (upper side D2 and lateral side D1) is preferred over D2 or D3 dissection, because all cases with lymph node metastasis were n1(+). We consider this to be the only treatment which guarantees full preservation of autonomic function.",
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Sawada, T, Hayakawa, T, Dohi, T, Ueno, M, Kinoshita, Y, Tsutsumi, K, Matsuda, M, Kajiyama, Y, Hashimoto, M, Udagawa, H, Watanabe, G & Tsurumaru, M 1997, 'The choice of an endoscopie resection or a surgical resection based on the surgical cases of early rectal cancer', Japanese Journal of Gastroenterological Surgery, vol. 30, no. 4, pp. 930-935. https://doi.org/10.5833/jjgs.30.930

The choice of an endoscopie resection or a surgical resection based on the surgical cases of early rectal cancer. / Sawada, Toshihito; Hayakawa, Takeshi; Dohi, Takehiko; Ueno, Masaki; Kinoshita, Yoshihiro; Tsutsumi, Kenji; Matsuda, Masamichi; Kajiyama, Yoshiaki; Hashimoto, Masashi; Udagawa, Harusi; Watanabe, Goro; Tsurumaru, Masahiko.

In: Japanese Journal of Gastroenterological Surgery, Vol. 30, No. 4, 01.01.1997, p. 930-935.

Research output: Contribution to journalArticle

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T1 - The choice of an endoscopie resection or a surgical resection based on the surgical cases of early rectal cancer

AU - Sawada, Toshihito

AU - Hayakawa, Takeshi

AU - Dohi, Takehiko

AU - Ueno, Masaki

AU - Kinoshita, Yoshihiro

AU - Tsutsumi, Kenji

AU - Matsuda, Masamichi

AU - Kajiyama, Yoshiaki

AU - Hashimoto, Masashi

AU - Udagawa, Harusi

AU - Watanabe, Goro

AU - Tsurumaru, Masahiko

PY - 1997/1/1

Y1 - 1997/1/1

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