An: 2013, Nr.3, Articol Nr. 8

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      ANATOMICAL AND SURGICAL ASPECTS IN EVALUATION OF MIDDLE RECTAL CARCINOMAS (Abstract): In recent years has grown the need to address the management of colorectal cancer from a multidisciplinary perspective, and this is mainly due to fast advancement of medical imaging technology. Objectives of this research will be to evaluate the role of paraclinical and imagistic examination in early diagnosis and prognosis of colorectal tumors. We will focus on vascular colorectal arrangement and neoangiogenesis processes in middle rectal carcinoma, in order to identify some aspects that can represent the basis of treatments which can stop this process, and also tumor development. Study was performed on a group of 10 patients diagnosed with middle rectal cancer at the Military Hospital “Iacob Czihac” Iasi. Patients were imagistic investigated and then we compared the results with intraoperative exploration, with the study of the resection specimens and pathologic examination results. In the studied cases was observed how tumor vascular involvement proportionally increases with the degree of local invasion, so in advanced stage it can be seen dilatated stasis veins, inside the mezorectum and also the infiltration of mesorectal limph nodes. Anterior location of these middle rectal tumors gives them the possibility to early invade the vagina in women or the bladder, prostate and seminal vesicles in men. On the other side, laterorectal situation is the most aggresive one, because here there are major blood vessels. Rectal cancer prognosis depends mainly on tumor stage and the quality of circumferential resection margins, involving here mesorectal state. Malignant pathology significantly alter colorectal vascular arhitecture, neoangiogeneseis having response in distance.

Key words: IMAGING METHOD, MIDDLE RECTAL CARCINOMA, VASCULAR SUPPLY