Study of Invasion into the Pelvic Plexus in Rectal Cancer by Fully-cut Preparations of the Pelvic Plexus

Keiko Suzuki, Shingo Kameoka, Kiyotaka Nakajima, Masahiro Kaneki, Kyoichi Hamano

Department of Surgery II, Tokyo Women's Medical College

Fully-cut preparations of the pelvic plexus were made from specimens resected from 20 patients undergoing non-pelvic plexus-preservative surgery for rectal cancer, in order to determine invasion of rectal cancer into the pelvic plexus. Invasion into the pelvic plexus was present in 3 (15%) of the 20 patients, and invasion was also observed in the interstitium surrounding the pelvic plexus. In the patients with pelvic plexus invasion, neural invasion was present within the colon wall, particularly perineural space invasion, which has been found to be involved in local recurrence. In these patients, the parietal depth was categorized as ss (a1) or deeper, and lymph node metastasis and lymphatic invasion were present, whereas there was no venous invasion. As for prognosis, local recurrence occurred in 2 of the 3 patients with pelvic plexus invasion, but in none of the negative patients. The presence of invasion into the pelvic plexus indicates the necessity of considering of neural invasion at the time of selection of an adequate technique for an autonomic nerve-preserving operation, and it was thought to be reliable if this preservative operation is used only for the patients with a parietal depth of pm or less, without lymph node metastasis.

Key words
rectal cancer, pelvic plexus, neural invasion, local recurrence

Reprint requests
Keiko Suzuki Department of Surgery II, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
December 7, 1994

To read the PDF file you will need Abobe Reader installed on your computer.