Introduction: Regarding the rate of local recurrences, improvement of survival rates and quality of life, the treatment of rectal cancer has registered a remarkable progress during the last two decades. This was possible through multidisciplinary and gradual development of rectal cancer management, where surgical resection remains the “key factor” and all surgical interventions considered radical involve mesorectal excision. The status of lymph nodes is probably the only and most important marker of global survival in patients with rectal cancer, which is associated with the risk of systemic dissemination rather than local recurrence.
Material and method: The aim of this study was to analyze the importance of mesorectal lymph nodes, in case of rectal cancer disseminated locally and in remote organs, based on treated rectal cancer cases at the 1st Surgery Clinic, Tîrgu Mureș between January 2000 and December 2009. During this period, out of the 618 recorded rectal cancer cases, in 505 cases the patients underwent surgical intervention where besides the rectal tumor, the perirectal lymphatic tissue was also excised.
Results: The performed histopathological examinations revealed in 223 cases lymph node invasion (stage III and stage IV). We also studied different surgical interventions regarding lymph node excision performed during rectal cancer surgery, analyzed the average number of excised perirectal (mesorectal) lymph nodes and the average number of lymph nodes with histopathologically confirmed tumor metastasis resulted from rectal resection.
Conclusion: In our study, we found that in surgical interventions involving resection with anastomosis the average number of lymph nodes per specimen is biger than the number recorded subsequent to abdominoperineal rectal resection.Therefore the resection with mesorectal excision is the best option for rectal cancer surgery any time is possible.