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12. Lymphangiography in the diagnosis of retroperitoneal node metastases in rectal cancer

Author

G. Bonadonna, Umberto Veronesi, Carlo Uslenghi, and Chiappa S

Subjects
Adult, Male, medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, Rectum, Retroperitoneal lymph node dissection, medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, Retroperitoneal Neoplasms, Aged, business.industry, Rectal Neoplasms, Carcinoma, Lymphography, General Medicine, Middle Aged, medicine.disease, Radiation therapy, medicine.anatomical_structure, Lymphatic Metastasis, Colonic Neoplasms, Lipiodol, Lymphadenectomy, Female, Lymph, Radiology, business, medicine.drug
Abstract

The retroperitoneal node chains in 36 patients with rectal and sigmoid cancer have been explored by lymphangiography (Lipiodol F). The lymphangiograms were definitely abnormal especially in the external iliac chains in 20 cases and suspicious in four. Iliac lymphadenectomy was performed in seven patients and was positive for metastatic involvement in three. The lymphangiographic findings could represent either a direct lymph pathway, connecting the rectum to the external iliac nodes, or a sign of retrograde metastases. Endolymphatic radiotherapy (Lipiodol F131I) was carried out in four patients. This therapeutic approach can be applied in patients with rectal cancer before surgery to irradiate small metastases. It is concluded that in all resectable patients with rectal, sigmoid and colon cancers lymphangiography should be routinely performed and lymphadenectomy carried out in those cases showing retroperitoneal metastases.

Published
1967

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