Difference between revisions of "Lower anterior resection for cancer grossing"

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The protocol deals with grossing a '''[[lower anterior resection]] for cancer''', abbreviated '''LAR4ca'''.  
The protocol deals with grossing a '''lower anterior resection for cancer''', abbreviated '''LAR4ca'''.  


==Introduction==
==Introduction==
This is a very common specimen. It is done for proximal [[colorectal carcinoma|rectal cancers]].
This is a very common specimen. It is done for proximal [[colorectal carcinoma|rectal cancer]].
 
When a LAR is not possible, as the cancer is too distal, an [[abdominoperineal resection]] is done.


==Protocol==
==Protocol==
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*Circumference - proximal end: ___ cm.
*Circumference - proximal end: ___ cm.
*Circumference - distal end: ___ cm.
*Circumference - distal end: ___ cm.
*Rectum lenght (distal margin to mesorectal reflection): ___ cm.
*Rectum length (distal margin to mesorectal reflection): ___ cm.


Appearance - external:
Appearance - external:
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Representative sections are submitted as follows:
Representative sections are submitted as follows:
*Proximal margin.
*Proximal margin.
*Distal margin.
*Distal margin.
*Tumour - deepest invasion.
*Tumour - deepest invasion.
*Additional sections of tumour (1 section/cm).
*Additional sections of tumour (1 section/cm).
*All polyps (if less than 10).
*All polyps (if less than 10).
*Normal appearing mucosa.
*Normal appearing mucosa.
*Lymph nodes.
*Lymph nodes.


===Protocol notes===
===Protocol notes===
*Recommended minimum number of lymph nodes is 12.<ref name=pmid25234197>{{Cite journal  | last1 = Ihnát | first1 = P. | last2 = Delongová | first2 = P. | last3 = Horáček | first3 = J. | last4 = Ihnát Rudinská | first4 = L. | last5 = Vávra | first5 = P. | last6 = Zonča | first6 = P. | title = The Impact of Standard Protocol Implementation on the Quality of Colorectal Cancer Pathology Reporting. | journal = World J Surg | volume =  | issue =  | pages =  | month = Sep | year = 2014 | doi = 10.1007/s00268-014-2796-4 | PMID = 25234197 }}</ref>
*‡ Usually submitted completely and [[en face]]; if the margin is close (<2 cm) [[on edge margin|on edge]] is typically preferred.
*† Recommended minimum number of lymph nodes is 12.<ref name=pmid25234197>{{Cite journal  | last1 = Ihnát | first1 = P. | last2 = Delongová | first2 = P. | last3 = Horáček | first3 = J. | last4 = Ihnát Rudinská | first4 = L. | last5 = Vávra | first5 = P. | last6 = Zonča | first6 = P. | title = The Impact of Standard Protocol Implementation on the Quality of Colorectal Cancer Pathology Reporting. | journal = World J Surg | volume =  | issue =  | pages =  | month = Sep | year = 2014 | doi = 10.1007/s00268-014-2796-4 | PMID = 25234197 }}</ref>


====Images====
====Images====
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===Alternate approaches===
===Alternate approaches===
==See also==
==See also==
*[[Donuts]].
===Related protocols===
===Related protocols===
*[[Sigmoidectomy for diverticular disease]].
*[[Sigmoidectomy for diverticular disease]].
*[[Abdominoperineal resection grossing]].


==References==
==References==
{{Reflist|2}}
{{Reflist|1}}


==External links==
==External links==

Latest revision as of 13:39, 2 January 2017

The protocol deals with grossing a lower anterior resection for cancer, abbreviated LAR4ca.

Introduction

This is a very common specimen. It is done for proximal rectal cancer.

When a LAR is not possible, as the cancer is too distal, an abdominoperineal resection is done.

Protocol

Specimen:

  • Lower anterior resection.

Dimensions:

  • Length: ___ cm.
  • Circumference - proximal end: ___ cm.
  • Circumference - distal end: ___ cm.
  • Rectum length (distal margin to mesorectal reflection): ___ cm.

Appearance - external:

  • Completeness of mesorectal excision: [complete].
  • Serosal aspect of bowel: [shiny].
  • Perforation: [present/not present].

Inking:

  • Circumferential margin: [black].
  • Serosal puckering: [blue].

Tumour characteristics:

  • Dimensions (along axis, circumferential, depth): ___ x ___ x ___ cm.
  • Distance to nearest mucosal margin: ___ cm, [distal] margin.
  • Distance to circumferential margin: ___ cm.
  • Circumferential location: [anterior/left/right/posterior/circumferential].

Representative sections are submitted as follows:

  • Proximal margin. ‡
  • Distal margin. ‡
  • Tumour - deepest invasion.
  • Additional sections of tumour (1 section/cm).
  • All polyps (if less than 10).
  • Normal appearing mucosa.
  • Lymph nodes. †

Protocol notes

  • ‡ Usually submitted completely and en face; if the margin is close (<2 cm) on edge is typically preferred.
  • † Recommended minimum number of lymph nodes is 12.[1]

Images

Alternate approaches

See also

Related protocols

References

  1. Ihnát, P.; Delongová, P.; Horáček, J.; Ihnát Rudinská, L.; Vávra, P.; Zonča, P. (Sep 2014). "The Impact of Standard Protocol Implementation on the Quality of Colorectal Cancer Pathology Reporting.". World J Surg. doi:10.1007/s00268-014-2796-4. PMID 25234197.

External links