Utilización del aclaramiento ganglionar
Palabras clave:
neoplasias del colon, neoplasias del recto, excisión del ganglio linfático, diagnóstico, cirugía colorrectal, laparotomíaResumen
El aclaramiento ganglionar es una técnica por medio de la cual se logra disolver la emulsión y decolorar los tejidos grasos corporales con el fin de identificar fácilmente las estructuras ganglionares. Mediante esta técnica se logró identificar hasta el 100% de los ganglios adicionales en el estudio de las piezas anatomopatológicas de cáncer colorrectal.
La técnica tuvo una importancia trascendental en el subgrupo de pacientes con tratamiento neoadyuvante que es el de mayor dificultad en el estudio convencional de patología. El 94% de los ganglios identificados con el aclaramiento eran menores de 5 mm. Existió un cambio de estadificación en 10% de los casos incluidos en el estudio piloto.
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Referencias bibliográficas
1. Di Cataldo A, Scilleta B, Latino R, Cocuzza A, Li Destri G. The surgeon as a prognostic factor in the surgical treatment of rectal cancer. Surg Oncol. 2007;16:S53-6.
2. Nagtegaal ID, van Krieken MJH. The multidisciplinary treatment of rectal cancer: pathology. Ann Oncol. 2007;18(Suppl.9):219-16.
3. Goldstein NS, Sanford W, Coffey M, Layfield LJ. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered. Am J Clin Pathol. 1996;106:209-16.
4. Mainprize KS, Hewavisinthe J, Savaje A, Mortensen M, Warren B. How many lymph nodes to stage colorectal carcinoma? J Clin Pathol. 1998;51:165-6.
5. Stewart BW, Kleihues P, editors. World cancer report. 1st edition. Lyon: IARC Press; 2003;198-202.
6. Torricelli P. Rectal cancer staging. Surg Oncol. 2007;16:S49-50.
7. American Gastroenterological Association. Colorectal cancer screening and surveillance: clinical guidelines and rationale -update based on new evidence. Gastroenterology. 2003;124:544-60.
8. Smith A, Khalifa MA, Law CH. Multimodal CME for surgeons and pathologists improves colon cancer staging. J Cancer Educ. 2003;18:81-6.
9. Brown HG, Luckasevic TM, Medich DS, Celebrezze JP, Jones SM. Efficacy of manual dissection of lymph nodes in colon cancer resections. Mod Pathol. 2004;17:402-6.
10. Sánchez W, Luna-Pérez P, Alvarado I, Labastida S, Herrera L. Modified clearing technique to identify lymph node metastases in post-irradiated surgical specimens from rectal adenocarcinoma. Arch Med Res. 1996;27:31-6.
11. Andreola S, Leo E, Belli F, Bufalino R, Tomasic G, Lavarino C, et al. Manual of dissection of adenocarcinoma of the lower third of the rectum specimens for detection of lymph node metastases smaller than 5 mm. Cancer. 1996;77:607-12.
12. Dworak O. Morphology of lymph nodes in the resected rectum of patients with rectal carcinoma. Pathol Res Pract. 1991;187:1020-4.
13. Grinnell R. Lymphatic metastases of carcinoma of the colon and rectum. Ann Surg. 1950;131:421-38.
14. Herrera L, Villarreal JR. Incidence of metastases from rectal adenocarcinoma in small lymph nodes detected by a clearing technique. Dis Colon Rectum. 1992;35:783-8.
15. Herrera-Ornelas L, Justiniano J, Castillo N, Petrelli NJ, Stulc JP, Mittelman A. Metastases in small lymph nodes from colon cancer. Arch Surg. 1987;122:1253-6.
16. Hida J, Mori N, Kubo R, Matsuda T, Morikawa E, Kitaoka M, et al. Metastases from carcinoma of the colon and rectum detected in small lymph nodes by the clearing method. J Am Coll Surg. 1994;178:223-8.
17. Rodríguez-Bigas MA, Maamoun S, Weber TK, Penetrante RB, Blumenson LE, Petrelli NJ. Clinical significance of colorectal cancer: metastases in lymph nodes <5 mm in size. Ann Surg Oncol. 1996;3:124-30.
18. Arav E, Picot M, De La Tour Du Pin E, Yaziji N, Majek E, Patey M, et al. How to optimize lymph node dissection in colorectal cancers. A technique for simple and efficacious clarification. Ann Pathol. 1999;19:147-50.
19. Amat I, Beloqui R, Del Llano P, Gómez-Dorronsoro M, Larrinaga B, Córdoba A, et al. Comparative results of ganglion dissection in cancer of the rectum with and without prior treatment of the adipose tissue. An Sist Sanit Navar. 2003;26:433-5.
20. Candela FC, Urmacher C, Brennan MF. Comparison of the conventional method of lymph node staging with a comprehensive fat-clearing method for gastric adenocarcinoma. Cancer. 1990;66:1828-32.
21. Hida J, Yasutomi M, Tokoro T, Kubo R. Examination of nodal metastases by a clearing method supports pelvic. Plexus preservation in rectal cancer surgery. Dis Colon Rectum. 1999;42:510-4.
22. Jass JR, Miller K, Northover JM. Fat clearance method versus manual dissection of lymph nodes in specimens of rectal cancer. Int J Colorrectal Dis. 1986;1:155-6.
23. Pichardo-Bahena R, Barredo PB, Méndez-Sánchez N Aclaramiento ganglionar técnicas e indicaciones. Med Sur 2001; 8 (4): 117-118.
24. Cawthorn S, Gibbs J. Clearance technique for the detection of lymph nodes in colorectal cancer. Br J Surg. 1986;73:58-60.
25. Newell KJ, Sawka BW, Rudrick BF. GEWF solution. Arch Pathol Lab Med. 2001;125:642-5.
2. Nagtegaal ID, van Krieken MJH. The multidisciplinary treatment of rectal cancer: pathology. Ann Oncol. 2007;18(Suppl.9):219-16.
3. Goldstein NS, Sanford W, Coffey M, Layfield LJ. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered. Am J Clin Pathol. 1996;106:209-16.
4. Mainprize KS, Hewavisinthe J, Savaje A, Mortensen M, Warren B. How many lymph nodes to stage colorectal carcinoma? J Clin Pathol. 1998;51:165-6.
5. Stewart BW, Kleihues P, editors. World cancer report. 1st edition. Lyon: IARC Press; 2003;198-202.
6. Torricelli P. Rectal cancer staging. Surg Oncol. 2007;16:S49-50.
7. American Gastroenterological Association. Colorectal cancer screening and surveillance: clinical guidelines and rationale -update based on new evidence. Gastroenterology. 2003;124:544-60.
8. Smith A, Khalifa MA, Law CH. Multimodal CME for surgeons and pathologists improves colon cancer staging. J Cancer Educ. 2003;18:81-6.
9. Brown HG, Luckasevic TM, Medich DS, Celebrezze JP, Jones SM. Efficacy of manual dissection of lymph nodes in colon cancer resections. Mod Pathol. 2004;17:402-6.
10. Sánchez W, Luna-Pérez P, Alvarado I, Labastida S, Herrera L. Modified clearing technique to identify lymph node metastases in post-irradiated surgical specimens from rectal adenocarcinoma. Arch Med Res. 1996;27:31-6.
11. Andreola S, Leo E, Belli F, Bufalino R, Tomasic G, Lavarino C, et al. Manual of dissection of adenocarcinoma of the lower third of the rectum specimens for detection of lymph node metastases smaller than 5 mm. Cancer. 1996;77:607-12.
12. Dworak O. Morphology of lymph nodes in the resected rectum of patients with rectal carcinoma. Pathol Res Pract. 1991;187:1020-4.
13. Grinnell R. Lymphatic metastases of carcinoma of the colon and rectum. Ann Surg. 1950;131:421-38.
14. Herrera L, Villarreal JR. Incidence of metastases from rectal adenocarcinoma in small lymph nodes detected by a clearing technique. Dis Colon Rectum. 1992;35:783-8.
15. Herrera-Ornelas L, Justiniano J, Castillo N, Petrelli NJ, Stulc JP, Mittelman A. Metastases in small lymph nodes from colon cancer. Arch Surg. 1987;122:1253-6.
16. Hida J, Mori N, Kubo R, Matsuda T, Morikawa E, Kitaoka M, et al. Metastases from carcinoma of the colon and rectum detected in small lymph nodes by the clearing method. J Am Coll Surg. 1994;178:223-8.
17. Rodríguez-Bigas MA, Maamoun S, Weber TK, Penetrante RB, Blumenson LE, Petrelli NJ. Clinical significance of colorectal cancer: metastases in lymph nodes <5 mm in size. Ann Surg Oncol. 1996;3:124-30.
18. Arav E, Picot M, De La Tour Du Pin E, Yaziji N, Majek E, Patey M, et al. How to optimize lymph node dissection in colorectal cancers. A technique for simple and efficacious clarification. Ann Pathol. 1999;19:147-50.
19. Amat I, Beloqui R, Del Llano P, Gómez-Dorronsoro M, Larrinaga B, Córdoba A, et al. Comparative results of ganglion dissection in cancer of the rectum with and without prior treatment of the adipose tissue. An Sist Sanit Navar. 2003;26:433-5.
20. Candela FC, Urmacher C, Brennan MF. Comparison of the conventional method of lymph node staging with a comprehensive fat-clearing method for gastric adenocarcinoma. Cancer. 1990;66:1828-32.
21. Hida J, Yasutomi M, Tokoro T, Kubo R. Examination of nodal metastases by a clearing method supports pelvic. Plexus preservation in rectal cancer surgery. Dis Colon Rectum. 1999;42:510-4.
22. Jass JR, Miller K, Northover JM. Fat clearance method versus manual dissection of lymph nodes in specimens of rectal cancer. Int J Colorrectal Dis. 1986;1:155-6.
23. Pichardo-Bahena R, Barredo PB, Méndez-Sánchez N Aclaramiento ganglionar técnicas e indicaciones. Med Sur 2001; 8 (4): 117-118.
24. Cawthorn S, Gibbs J. Clearance technique for the detection of lymph nodes in colorectal cancer. Br J Surg. 1986;73:58-60.
25. Newell KJ, Sawka BW, Rudrick BF. GEWF solution. Arch Pathol Lab Med. 2001;125:642-5.
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Publicado
2008-12-20
Cómo citar
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Quintero, S.; Lombana, L. J.; Jaramillo, L. F.; Ramírez, Y. P. Utilización Del Aclaramiento Ganglionar. Rev Colomb Cir 2008, 23, 210-216.
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