الفهرس 
I. INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Colorectal cancer is the fourth most frequently diagnosed cancer and
the second leading cause of cancer deaths in the United States. In Egypt,
colorectal cancer is the fourth most commonly diagnosed cancer in both men
and women. Rectal cancer comprises approximately 30% of the
malignancies arising in the large bowel. TNM stage of Colon cancer
correlates with survival rates and prognosis estimation. The accuracy of (N)
staging increases with the number of lymph nodes examined. The evaluation
of at least 12 lymph nodes is widely cited in clinical guidelines. It has been
reported that in 75% of all colorectal specimens adequate numbers of lymph
nodes are not found or examined.
The aim of this study was to evaluate the effect of ex-vivo methylene
blue injection into the feeding mesocolic artery for improving lymph node
harvest in colorectal cancer.
This study included 50 patients with resectable colorectal cancer.
patients were randomly divided into two equal groups; a stained group, in
which surgical resection specimens were subjected to ex vivo methylene
blue injection into the feeding mesocolic artery, and an unstained group, in
which conventional pathological assessment was done.
Total lymph node harvest, number of metastatic lymph nodes, nodal
size distribution and the effect of various factors that can influence nodal
harvest were assessed in each of the study groups.
There were no statistically significant differences between the study
groups according to demographic, anatomical, laboratory and histological
criteria. Also, differences between the study groups regarding preoperative
staging, type of operation, were statistically insignificant.
There was a major improvement in lymph node harvest in the stained
group as compared with the unstained one. This improvement was attributed
to identifying more small lymph nodes (3 mm). According to the current
AJCC and IUAC guidelines, lymph node recovery was adequate in 96% and
76% of cases of the stained and unstained groups, respectively. A significant
improvement was also detected in the number of metastatic lymph nodes
identified in the stained group.
Following pathological staging, 84% and 52% of cases of the stained
and unstained groups, respectively, were staged as stage III. There was a
significant difference between the study groups regarding pathological
staging postoperative .
None of the other factors that can influence nodal harvest had a
significant effect in any of the study groups. Methylene blue injection had a
more powerful impact on nodal harvest either the total or metastaic number
of lymph nodes