Rectal cancer at the peritoneal reflection. Preoperative MRI accuracy and histophatologic correlation. Prospective study.

Autores de IIS La Fe

• Álvaro García-Granero García-Fuster

  Autor

• 

  Matteo Frasson

  Autor

• Blas Flor Lorente

  Autor

• Eduardo García-Granero Ximénez

  Autor

Participantes ajenos a IIS La Fe

• Álvarez Sarrado E
• Giner Segura F
• Batista Domenech A
• Rudenko P

Grupos

• Cirugía digestiva y Cuidados perioperatorios

  

  Leader

  Matteo Frasson

Abstract

INTRODUCTION: To investigate magnetic resonance imaging (MRI) accuracy for determining the location of rectal tumors with respect to the peritoneal reflection (PR) and its potential involvement. METHODS: Prospective study of 161 patients ongoing surgery for rectal cancer. A double-ink method has been aplied to examine surgical specimen, orange ink for the serosal surface and indian ink for the mesorrectal margin, and assess preoperative MRI accuracy. RESULTS: Twenty-two tumors were located above, 65 at and 74 below PR. MRI accuracy was 90.6% for determining tumor's location with respect to the PR and 80.5% for defining peritoneal involvement. For classifying tumors according to their intra or extraperitoneal location an accuracy of 92.5% was set for MRI. Histophatologic peritoneal involvement was found in 28.7% of tumors located above or at the PR. CONCLUSIONS: Magnetic resonance imaging accurately predicts the location of rectal tumors with respect to the PR and its potential involvement. The double-ink method is useful to assess serosal involvement (pT4a) and to distinguish mesorrectal fascia from the peritonealized surface.

Copyright © 2021 AEC. Published by Elsevier España, S.L.U. All rights reserved.

Keywords

• Cáncer de recto; Doble colorante; Double dye; Grados de Shepherd; Infiltración serosa; Magnetic resonance imaging; Peritoneal involvement; Peritoneal reflection; Rectal cancer; Reflexión peritoneal; Resonancia magnética; Shepherd’s groups