Difference between revisions of "Right hemicolectomy for cancer grossing"

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==Protocol==
==Protocol==
Specimen:
*Right hemicolectomy.
Dimensions:
*Length large bowel: ___ cm.
*Length small bowel: ___ cm.
*Circumference - proximal end: ___ cm.
*Circumference - distal end: ___ cm.
*Appendix: length ___ cm, diameter ___ cm.
Appearance - external:
*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===
===Protocol notes===
*The retroperitoneal margin in right hemicolectomies should be treated like the radial margin in total mesorectal excisions; it should be inked.<ref>URL: [http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13954 http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13954]. Accessed on: 6 February 2013.</ref> Involvement is a poor prognosticator.<ref name=pmid15790712/>
*‡ 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>
*§ The retroperitoneal margin in right hemicolectomies should be treated like the radial margin in total mesorectal excisions; it should be inked.<ref>URL: [http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13954 http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13954]. Accessed on: 6 February 2013.</ref> Involvement is a poor prognosticator.<ref name=pmid15790712/>


Image:
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===Alternate approaches===
===Alternate approaches===
==See also==
==See also==
===Related protocols===
===Related protocols===

Latest revision as of 03:35, 18 October 2014

This protocol deals with right hemicolectomy for cancer grossing.

It is done for cancers in the cecum, right colon, and appendix. Right hemicolectomies are also commonly done for Crohn's disease; this is dealt with in a separate article.

Introduction

It is very common.

Protocol

Specimen:

  • Right hemicolectomy.

Dimensions:

  • Length large bowel: ___ cm.
  • Length small bowel: ___ cm.
  • Circumference - proximal end: ___ cm.
  • Circumference - distal end: ___ cm.
  • Appendix: length ___ cm, diameter ___ cm.

Appearance - external:

  • 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]
  • § The retroperitoneal margin in right hemicolectomies should be treated like the radial margin in total mesorectal excisions; it should be inked.[2] Involvement is a poor prognosticator.[3]

Image:

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.
  2. ↑ URL: http://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13954. Accessed on: 6 February 2013.
  3. ↑ 3.0 3.1 Bateman, AC.; Carr, NJ.; Warren, BF. (Apr 2005). "The retroperitoneal surface in distal caecal and proximal ascending colon carcinoma: the Cinderella surgical margin?". J Clin Pathol 58 (4): 426-8. doi:10.1136/jcp.2004.019802. PMID 15790712.
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