Method for postoperative control of complete mesorectal excision

This study aimed at a more objective evaluation of the specimen after total mesorectal excision [14]. For this reason, a method yielding a simple stai ned preparation of the totally excised mesorectum was developed. By postope rative injection of 10 mi of an ink solution into the A. rectalis superior of 15 specimens, the arterial mesorectal vascular tree was filled. All spec imens had been collected by means of total mesorectal excision. In two specimens, in wich the mesorectal sheath fascia had been injured due to the surgical manipulation, we observed the leakage of ink from the meso rectum even during the injection. In three further specimens, some ink leak age in the form of dots occurred from small opened arterioles after the inj ection was performed. No ink leakage was observed in the remaining specimen s. Prior to the ink injection, thirteen specimens were macroscopically test ed and found intact. Three of the fifteen specimens exhibited minor lesions of the mesorectum that would not have been detected macroscopically withou t ink tagging. The comparison of the findings provided by the surgeon with the histopathological evaluation showed that those specimens in which no in k leakage occurred had an unimpaired mesorectal sheath fascia. These specim ens correspond to the complete excision of the mesorectum and the removal o f the tumor in a cancer-sealed package as long as the circumferential rim o f the specimen has not been infiltrated by the tumor.