Material

Seventy-one specimens were selected to perform a morphological investigation. They represented rectums with adenocarcinoma and contiguous anatomic structures (pararectal and ischiorectal tissues, external and internal sphincters, and perianal skin) obtained as a result of curative APR. In these series of specimens, the lower margin of the tumour was located within 5 cm of the level of perianal skin. Specimens obtained in the course of palliative APR of the rectum or with positive lateral margin were not analysed. All the tumours possessed adenocarcino-mas that differed in the degree of differentiation. A high degree of differentiation was characteristic for 19 (26.8%) adenocarcinomas, 44 (62.0%) adenocarcinomas had a good degree of differentiation, whereas a low degree was characteristic for 8 (11.2%) adenocarcinomas. The T2 stage was revealed in 15 observations, T3 in 53 specimens and T4 in three cases. Thus, 68 (95.8%) of 71 tumours examined did not exceed the visceral fascia of the rectum. In three patients only (4.2%) were the contiguous organs involved in malignancy: vagina (1.4%) and prostate (2.8%). The margin of resection of invaded organ remained intact in all three cases. In 30 (42.3%) cases, the tumours had demonstrated involvement of the upward lymph nodes. In 41 (57.3%) cases metastases to regional lymphatic nodes were not observed. Most of the tumours had a near-spherical shape. The mean values of their longitudinal and transverse dimensions were as follows: 50.5 (35-65)X49 (25-80) mm.

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