"Evaluation of safe resection margins in rectal carcinoma"@en . . "RIV/00216208:11150/14:10284382!RIV15-MSM-11150___" . "8"^^ . . "RIV/00216208:11150/14:10284382" . . "0035-9351" . . . "Ry\u0161ka, Ale\u0161" . . . "Rozhledy v chirurgii" . . . "Ferko, Alexander" . "2" . "Problematika stanoven\u00ED bezpe\u010Dn\u00FDch resek\u010Dn\u00EDch okraj\u016F u karcinomu rekta" . "6"^^ . "Problematika stanoven\u00ED bezpe\u010Dn\u00FDch resek\u010Dn\u00EDch okraj\u016F u karcinomu rekta" . "interdisciplinary approach; mesorectal excision quality assessment; circumferential resection margin; total mesorectal excision; rectosigmoid cancer"@en . "Problematika stanoven\u00ED bezpe\u010Dn\u00FDch resek\u010Dn\u00EDch okraj\u016F u karcinomu rekta"@cs . . "P(LM2010004)" . "Fakt, \u017Ee negativn\u00ED cirkumferentn\u00ED resek\u010Dn\u00ED okraj a chirurgem kvalitn\u011B proveden\u00E1 tot\u00E1ln\u00ED mezorekt\u00E1ln\u00ED excize pat\u0159\u00ED u karcinomu rektosigmoidea k nejd\u016Fle\u017Eit\u011Bj\u0161\u00EDm prognostick\u00FDm faktor\u016Fm, je ji\u017E v\u0161eobecn\u011B zn\u00E1m\u00FD. Oba parametry v\u00FDrazn\u011B ovliv\u0148uj\u00ED v\u00FDskyt lok\u00E1ln\u00ED recidivy n\u00E1doru i vzd\u00E1len\u00FDch metast\u00E1z a souvisej\u00ED tak s d\u00E9lkou p\u0159e\u017Eit\u00ED pacienta. \u00DAlohou chirurga je prov\u00E9st co mo\u017En\u00E1 nejkompletn\u011Bj\u0161\u00ED mezorekt\u00E1ln\u00ED excizi, tedy odstranit rektum i s neporu\u0161en\u00FDm v\u00E1lcem mezorekt\u00E1ln\u00EDho tuku. \u00DAlohou patologa p\u0159i hodnocen\u00ED tot\u00E1ln\u00EDch mezorekt\u00E1ln\u00EDch exciz\u00ED je v prvn\u00ED \u0159ad\u011B uplatn\u011Bn\u00ED zcela odli\u0161n\u00E9ho postupu zpracov\u00E1n\u00ED vzorku ve srovn\u00E1n\u00ED s ostatn\u00EDmi resek\u00E1ty tlust\u00E9ho st\u0159eva s karcinomem. P\u0159i hodnocen\u00ED resek\u00E1tu je vedle tradi\u010Dn\u011B stanovovan\u00FDch parametr\u016F naprosto z\u00E1sadn\u00ED posouzen\u00ED dal\u0161\u00EDch aspekt\u016F specifick\u00FDch pr\u00E1v\u011B pro karcinom rekta, jmenovit\u011B vzd\u00E1lenost n\u00E1doru od cirkumferentn\u00EDho (radi\u00E1ln\u00EDho) resek\u010Dn\u00EDho okraje a kvalita mezorekt\u00E1ln\u00ED excize. Pro kvalifikovan\u00E9 zhodnocen\u00ED v\u0161ech parametr\u016F je nutn\u00E1 znalost cel\u00E9 \u0159ady klinick\u00FDch \u00FAdaj\u016F (v\u00FDsledky p\u0159edopera\u010Dn\u00EDch zobrazovac\u00EDch vy\u0161et\u0159en\u00ED, peropera\u010Dn\u00ED n\u00E1lez). K n\u00E1sledn\u00E9mu objektivn\u00EDmu vyhodnocen\u00ED t\u011Bchto parametr\u016F je nutn\u00E9 zaveden\u00ED standardizovan\u00E9ho postupu zpracov\u00E1n\u00ED resek\u00E1tu i jeho makroskopick\u00E9ho a mikroskopick\u00E9ho vy\u0161et\u0159en\u00ED. Tento postup se op\u00EDr\u00E1 zejm\u00E9na o standardizovanou makroskopickou fotodokumentaci celistvosti mezorekt\u00E1ln\u00EDho povrchu, zpracov\u00E1n\u00ED formou paraleln\u00EDch \u0159ez\u016F a c\u00EDlen\u00FD odb\u011Br vzork\u016F tk\u00E1n\u011B k histologick\u00E9mu vy\u0161et\u0159en\u00ED. Zcela nezbytn\u00E1 je velmi \u00FAzk\u00E1 mezioborov\u00E1 spolupr\u00E1ce chirurga a patologa v r\u00E1mci multidisciplin\u00E1rn\u00EDho t\u00FDmu, poskytuj\u00EDc\u00ED oboustrannou zp\u011Btnou vazbu."@cs . . "Fakt, \u017Ee negativn\u00ED cirkumferentn\u00ED resek\u010Dn\u00ED okraj a chirurgem kvalitn\u011B proveden\u00E1 tot\u00E1ln\u00ED mezorekt\u00E1ln\u00ED excize pat\u0159\u00ED u karcinomu rektosigmoidea k nejd\u016Fle\u017Eit\u011Bj\u0161\u00EDm prognostick\u00FDm faktor\u016Fm, je ji\u017E v\u0161eobecn\u011B zn\u00E1m\u00FD. Oba parametry v\u00FDrazn\u011B ovliv\u0148uj\u00ED v\u00FDskyt lok\u00E1ln\u00ED recidivy n\u00E1doru i vzd\u00E1len\u00FDch metast\u00E1z a souvisej\u00ED tak s d\u00E9lkou p\u0159e\u017Eit\u00ED pacienta. \u00DAlohou chirurga je prov\u00E9st co mo\u017En\u00E1 nejkompletn\u011Bj\u0161\u00ED mezorekt\u00E1ln\u00ED excizi, tedy odstranit rektum i s neporu\u0161en\u00FDm v\u00E1lcem mezorekt\u00E1ln\u00EDho tuku. \u00DAlohou patologa p\u0159i hodnocen\u00ED tot\u00E1ln\u00EDch mezorekt\u00E1ln\u00EDch exciz\u00ED je v prvn\u00ED \u0159ad\u011B uplatn\u011Bn\u00ED zcela odli\u0161n\u00E9ho postupu zpracov\u00E1n\u00ED vzorku ve srovn\u00E1n\u00ED s ostatn\u00EDmi resek\u00E1ty tlust\u00E9ho st\u0159eva s karcinomem. P\u0159i hodnocen\u00ED resek\u00E1tu je vedle tradi\u010Dn\u011B stanovovan\u00FDch parametr\u016F naprosto z\u00E1sadn\u00ED posouzen\u00ED dal\u0161\u00EDch aspekt\u016F specifick\u00FDch pr\u00E1v\u011B pro karcinom rekta, jmenovit\u011B vzd\u00E1lenost n\u00E1doru od cirkumferentn\u00EDho (radi\u00E1ln\u00EDho) resek\u010Dn\u00EDho okraje a kvalita mezorekt\u00E1ln\u00ED excize. Pro kvalifikovan\u00E9 zhodnocen\u00ED v\u0161ech parametr\u016F je nutn\u00E1 znalost cel\u00E9 \u0159ady klinick\u00FDch \u00FAdaj\u016F (v\u00FDsledky p\u0159edopera\u010Dn\u00EDch zobrazovac\u00EDch vy\u0161et\u0159en\u00ED, peropera\u010Dn\u00ED n\u00E1lez). K n\u00E1sledn\u00E9mu objektivn\u00EDmu vyhodnocen\u00ED t\u011Bchto parametr\u016F je nutn\u00E9 zaveden\u00ED standardizovan\u00E9ho postupu zpracov\u00E1n\u00ED resek\u00E1tu i jeho makroskopick\u00E9ho a mikroskopick\u00E9ho vy\u0161et\u0159en\u00ED. Tento postup se op\u00EDr\u00E1 zejm\u00E9na o standardizovanou makroskopickou fotodokumentaci celistvosti mezorekt\u00E1ln\u00EDho povrchu, zpracov\u00E1n\u00ED formou paraleln\u00EDch \u0159ez\u016F a c\u00EDlen\u00FD odb\u011Br vzork\u016F tk\u00E1n\u011B k histologick\u00E9mu vy\u0161et\u0159en\u00ED. Zcela nezbytn\u00E1 je velmi \u00FAzk\u00E1 mezioborov\u00E1 spolupr\u00E1ce chirurga a patologa v r\u00E1mci multidisciplin\u00E1rn\u00EDho t\u00FDmu, poskytuj\u00EDc\u00ED oboustrannou zp\u011Btnou vazbu." . "Evaluation of safe resection margins in rectal carcinoma"@en . "Problematika stanoven\u00ED bezpe\u010Dn\u00FDch resek\u010Dn\u00EDch okraj\u016F u karcinomu rekta"@cs . "39796" . "6"^^ . . . . "Had\u017Ei Nikolov, Dimitar" . "11150" . "\u00D6rhalmi, Julius" . "The fact that surgically well performed total mesorectal excision with negative circumferential resection margin represents one of the most important prognostic factors in colorectal carcinoma is already well known. These parameters significantly affect the incidence of local tumour recurrence as well as distant metastasis, and are thus related to the duration of patient survival. The surgeon's task is to perform mesorectal excision as completely as possible, i.e., to remove the rectum with an intact cylinder of mesorectal fat. The approach of the pathologist to evaluation of total mesorectal excision specimens differs greatly from that of resection specimens from other parts of the large bowel. Besides evaluation of the usual parameters for colon cancer staging, it is essential to assess certain additional factors specific to rectal carcinomas, namely tumour distance from circumferential (radial) resection margins and the quality of the mesorectal excision. In order to accurately evaluate these parameters, knowledge of a wide range of clinical data is indispensable (results of preoperative imaging, intraoperative findings). For objective evaluation of these parameters it is necessary to introduce standardized procedures for resection specimen processing and macro and microscopic examination. This approach is based mainly on standardized macroscopic photodocumentation of the integrity of the mesorectal surface. Parallel transverse sections of the resection specimens are made with targeted tissue sampling for histological examination. It is essential to have close coopertation between surgeons and pathologists within a multidisciplinary team enabling mutual feedback."@en . . "[A33FAC57DB4B]" . . "Hovorkov\u00E1, Eva" . . . "Chobola, Milan" . . . "93" . . . "CZ - \u010Cesk\u00E1 republika" .