2022 Volume 64 Issue 5 Pages 1099-1105
Background: In determining the surgical procedure for low rectal cancer, the resection margin is very important. Pillar-like elevation (PE) of the mucosa extending from the distal tumor edge is often observed during preoperative colonoscopy. In this study, we examined the clinicopathological significance of PE.
Method: A total of 94 patients with lower rectal cancer who underwent surgical resection at the National Defense Medical College were analyzed. We investigated the relationship between PE and clinicopathologic findings that included the length of intramural cancer spread.
Results: PE was observed in 10 cases (10.6%). Distal intramural cancer spread was observed more frequently in PE-positive cases (60.0%) than in PE-negative cases (9.5%) (P = 0.0006). In contrast, PE length did not correlate with the length of intramural cancer spread.
Conclusion: PE was not indicative of the extent of intramural distal tumor spread. Even if PE is observed preoperatively, it may be sufficient to take the distal resection margin recommended in the JSCCR guidelines.
