Re-fixation in a lymph node revealing solution is a powerful method for identifying lymph nodes in colorectal resection specimens

Eur J Surg Oncol. 2006 May;32(4):426-9. doi: 10.1016/j.ejso.2006.02.002. Epub 2006 Mar 13.


Aim: To verify an impact of a lymph node revealing solution (LRS) on the number of lymph nodes (LN) revealed in colorectal resection specimens.

Material and method: Fifty-nine cases of rectosigmoid carcinomas divided into two subgroups-stage pT2&3 (20 cases) and ypT2&3 (with pre-operative radiotherapy-39 cases)-were formalin fixed for 42-72 h, serially sectioned and re-fixed in LRS containing ethanol, diethyl ether, glacial acetic acid, and formalin for 24 h. The number of LNs was matched to a control group consisting of 34 cases of colorectal carcinoma, 14 pT2&3 and 20 ypT2&3 rectosigmoid carcinomas examined routinely. Results were statistically tested by Student's t-test.

Results: In the study group the total number of revealed LNs was 869, range 1-48, average 14.7 per specimen, median 15. In the control group the number of LNs was 200, range 0-13, average 5.9 per specimen, median 6. The difference between the study and the control group was statistically significant (P = 0.05).

Conclusion: Using LRS leads to a significant increase in the number of revealed LNs in colorectal resection specimens and makes it possible to find more than 12 LNs in a majority of stage pT2 and pT3 adenocarcinomas.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetic Acid*
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Colectomy / methods*
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Diagnosis, Differential
  • Ethanol*
  • Ether*
  • Formaldehyde*
  • Humans
  • In Vitro Techniques
  • Lymph Node Excision*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Reproducibility of Results
  • Retrospective Studies
  • Tissue Fixation / methods*


  • lymph node revealing solution
  • Ether
  • Formaldehyde
  • Ethanol
  • Acetic Acid