摘要
The interesting contribution of Qin et al.[1]about radiation injury on the rectum deserves to be integrated with observations regarding the equivalent damage to the perineal striated muscles.In approaching this topic,not yet extensively studied,we were interested at first in delineating its basic pathology by histological methods,as already proposed[2,3].For this,we selected from our anatomopathological archive 20 surgical specimens of abdominoperineal resections.In the first group,we enclosed 10 surgical specimens of lower rectal cancers operated on 5-6 weeks after a neoadjuvant radiochemotherapy,consisting of 50 Gy,fractioned in 5 weeks,and associated with a FOLFOX pharmacological treatment.In the second group,we included 5 cases of the same pathology,at a lower stage,and submitted for surgery 10 days after a‘short-term’neoadjuvant radiotherapy of 25 Gy in 5 fractions over 1 week.A third group encompassed 5 surgical specimens of abdominoperineal resection,performed for recurrent anal cancer 1 year after the same radiation treatment of 50 Gy as applied in the first group.From our study,we excluded cases with neoplastic infiltration of the perineal muscles,previous perineal surgery,radiation or trauma,systemic diseases such as diabetes,vasculitis,connective-tissue or musculoskeletal disorders,manifest atherosclerosis,morbid obesity,and poor nutrition.Clearly,the second and third groups were implemented for dose-and timerelated controls,in comparison to the first group.The perineal striated muscles found in the specimens were extensively studied with serial histological sections of 4mm and different staining techniques(Haematoxylin-Eosin,Trichrome Masson,and Mallory Azan).
