The Study Of Lymph Node Metastasis Around The Root Of Inferior Mesenteric Vessel In Radical Resection Of Rectal Cancer

Objective: To observe of the lymph node metastasis around the root ofinferior mesenteric vessel in the radical resection of rectal cancer, analyze therelated factors during the metastasis, and discuss the clinical significance ofscavenging the root of inferior mesenteric vessel in the rectal cancer surgery.Methods: Two hundred and sixty-three patients with rectal cancerproved by post-operative pathology were admitted from January2011toDecember2013in Taizhou People Hospital, Jiangsu Province. The teamincluded149males and114females, and the age of onset was64.4±10.97years. The data, such as the age, gender, tumor size, the ratio of tumor inintestinal canal, tumor typing, tissue typing, cell differentiation, cancerembolus, involved nerve, infiltrating depth, hepatic metastasis, and operativemethod were analyzed in the radical resection of rectal cancer. The2test wasused to compare the differences in the above-mentioned index. A two-sidedprobability level of0.05was chosen for statistical significance. Statisticalanalysis was performed by the use of SPSS for Windows (version19.0; IBMSPSS Statistics, IBM Corporation, Armonk, NY).Results: Forty-four cases out of the263patients had lymph nodemetastasis around the root of inferior mesenteric vessel, and the rate of lymphnode metastasis was16.7%. In the752nodes examined by histopathology,143nodes had metastasis, and the rate of meatstasis is19.0%. Single factoranalysis showed that tumor diameter (2=41.8, P＜0.01）, the rate of tumor to =7.34,P＜0.01）, tissuetyping（2=72.99,P＜0.01）, differentiation degree（2=59.49,P＜0.01）,infiltrating depth（2=47.51,P＜0.01）, hepatic metastasi（s2=17.39,P＜0.01）,cancer embolus（2=7.08,P＜0.01） and involved nerve（2=6.29,P＜0.05）had a influence on the lymph node metastasis around the root of inferiormesenteric vessel. Multiple factors logistic analysis also showed that tissuetyping, differentiation degree, tumor diameter, infiltrating depth and tumorlocation were correlated with the lymph node metastasis around the root ofinferior mesenteric vessel（P=0.00,0.00,0.00,0.018,0.036respectively）.Conclusions: The lymph node metastasis around the root of inferiormesenteric vessel in the radical resection of rectal cancer is related with tissuetyping, differentiation degree, tumor diameter, infiltrating depth, and tumorlocation. The tumor diameter more than5centimeters, mucinousadenocarcinoma, poorly differentiated adenocarcinoma, location beyond theperitoneal reflextion, infiltrating depth achieving T3grade, should have aradical lymph node dissection around the root of inferior mesenteric vessel inorder to have a good prognosis.