Clinical Analysis Of Lymph Nodes Metastasis Around The Root Of Inferior Mesenteric Vessel In The Radical Operation Of Rectal Cancer

Objective: To collect the information of lymph node metastasis around the root of inferior mesenteric vessel in the radical operation of rectal cancer,analyze the factors which may affect the rule of the metastasis,and discuss the significance of sweeping lymph nodes around the root of inferior mesenteric vessel in the radical operation of rectal cancer.Methods: Two hundred and seventeen patients with rectal cancer proved by post-operative pathology were admitted from October 2014 to October 2015 in The First Affiliated Hospital of Wannan Medical College.All the cases were accepted sweeping lymph nodes around the root of inferior mesenteric vessel in the radical operation,and with the specimens marked and inspected.To analyze the relevance between lymph nodes metastasis and some factors,such as the gender,age,tumor location,tumor diameter,the ratio of tumor in intestinal canal,tumor typing,differentiation degree,infiltrating depth,tissue typing,cancer embolus,involved nerve,hepatic metastasis,and surgical options.All the above-mentioned index were compared by using the ?2 test,statistical analysis was performed by using the SPSS17.0.Results: 29 cases among the 217 patients had lymph nodes metastasis around the root of inferior mesenteric vessel,and the rate of lymph node metastasis was 13.36%(29/217).525 lymph nodes had been examined by histopathology,the average was2.50±1.53.67 lymph nodes had metastasis,the rate was 12.76%(67/525).The results of the statistics and analysis showed that differentiation degree(?2=10.373,P=0.006<0.05),tumor diameter(?2=26.990,P <0.001),the ratio of tumor in intestinal canal(?2=8.137,P=0.004<0.05),tumor location(?2=5.315,P=0.021<0.05),tissue typing(?2=49.334,P<0.001),cancer embolus(?2=6.115,P= 0.013<0.05),involved nerve(?2=7.997,P=0.005<0.05),hepatic metastasis(?2=16.200,P<0.001)and infiltrating depth(?2=28.823,P<0.001)were all in connection with lymph nodes metastasis around the root of inferior mesenteric vessel in the radical operation of rectal cancer.Conclusion: The rule of the lymph nodes metastasis around the root of inferior mesenteric vessel in the radical operation of rectal cancer is related with differentiation degree(low differentiative),tumor diameter(?5cm),the ratio of tumor in intestinal canal(more than half a circle),tumor location(above the peritoneum),tissue typing(mucinous adenocarcinoma),cancer embolus,involved nerve,hepatic metastasis and infiltrating depth(T3?T4).Cases that have above-mentioned factors should have radical lymph node dissection around the root of inferior mesenteric vessel in the radical operation of rectal cancer.