Abstract
The aim of our study was to investigate the lymph node metastasis of mesorectum and ischiorectal foss in ultra-low rectal cancer and its influence on the surgical procedure selection. Large slices and tissue microarray technology were used to detect metastasis lymph nodes from 23 dissected specimens of ultra-low rectal cancer. 415 lymph nodes were detected in the 23 specimens. 169 and 59 lymph nodes were metastasis and micrometastasis, respectively. Twelve specimens were diagnosed with lymph node metastasis, while other 4 specimens were with lymph node micrometastasis. There were 29.0% (49/169) and 17.2% (29/169) metastatic lymph nodes located in the outer and anterior region of mesorectum. There were 2 cases with ischiorectal fossa lymph node metastasis and 1 case with micrometastasis. The 3 metastatic cases were only 13% (13/23) of all the 23 cases. There is regional lymph node metastasis existing in ultra-low rectal cancer. The metastatic incidences in distal mesorectum and ischiorectal fossa are relatively low. Considering Miles operation as the standard surgical procedure for ultra-low rectal cancer should be evaluated renewedly.
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