대한대장항문학회

A Histopathological review was performed in 48 cases of rectal carcinoma which had<br>low anterior resection with EEA stapler at the Dept. of General Surgery Hanyang<br>University Hospital from Jan. 1990 to July 1992.<br>We obtained following results.<br>1) The mean age of 48 patients was 56.5 years(range from 32 to 81 years), sex ratio<br>was 1：1 and the peak incidence of age was 60∼69.<br>2) The frequent symptoms were bloody stool(79.2%), bowel habit change(47.9%), small<br>caliber stool(35.4%), abdominal Pain(22.9%), and weight loss(14.6%).<br>3) The level of tumor was as follows:<br>12 cases(25.0%) in above 10 cm, 34 cases(70.8%) in 5∼10 cm, 2 cases(4.2%) in below<br>5 cm.<br>4) All reported cases were adenocarcinoma.<br>The Astler-Coller classification were B<sub>1</sub> in 8(16.7%) patients,<br>B<sub>2</sub> in 15(31.3%) patients and C<sub>2</sub> in 25(52.0%) patients.<br>5) The reseated margin beloved the tumor was followed:<br>9 cases(18.8%) in below 1 cm, 10 cases(20.8%) in 1∼2cm, 17 cases(35.4%) in 2∼3cm,<br>6 cases(12.4%) in 3∼4 cm, 3 cases(6.3%) in 4∼5 cm, and 3 cases(6.3%) in above 5 cm.<br>All surgical margins were free of tumor.<br>The distance between distal margin and tumor was not significant factor of recurrence<br>(P>0.05).<br>6) The tumor size was as follows:<br>2 cases(4.2%) in less than 3 cm, 21 cases(43.7%) in 3∼5 cm, 17 cases(35.4%) in 5∼7<br>cm, and 8 cases(16.7%) in more than 7 cm. The tumor size was not significant factor of<br>recurrence(P>0.05).<br>7) All cases were tubular type in histological pattern.<br>8) The differentiation of tumor was well differentiation in 5(10.4%) cases, moderate in<br>35(72.9%) cases, and poor in 8(16.7%) cases.<br>The differentiation of tumor was not significant factor of recurrence(P>0.05).<br>9) The invasion pattern to around tissue was pushing type in 9 cases, infiltrative type<br>in 27 cases, and mixed type in 12 cases.<br>And it was not significant factor of recurrence(P>0.05).<br>10) There was lymphatic invasion of tumor in 26 cases, vascular invasion in 12 cases,<br>and neural invasion in 7 cases.<br>But these were not significant factors of recurrence(P>0.05).<br>11) There was no death in 30 days postoperatively, the soiling and voiding difficulty<br>were occured temporary in 7 cases. And post operative leakage of anastomotic site was<br>occured in 2 cases.<br>The local reccurrence of anastomotic site or metastasis to other organs were found in<br>8(16.7%) cases of 48 patients.<br>