Intraoperative Rectal Irrigation for Prevention of Implantation Metastasis Using a Double Concentric Sump Tube

Abstract

To prevent implantation metastases of rectal cancer during surgery, a new double concentric sump tube, 33 Fr. sized in diameter (Sumitomo Bakelite Co., Tokyo), was modified and introduced for intraoperative rectal irrigation on 10 patients undergone anterior resection for rectal or rectosigmoid cancer. 1000 ml of normal saline was used for intraluminal irrigation of the anal side of the rectum from tumor within 10 minutes and a cytological investigation of collected fluid was carried out to assess the effect of irrigation. As a result, 7 out of 10 patients were found to be positive cytology at the beginning, and none of the patients had tumor cells in the collected fluid at the end of irrigation. The result shows that this simple method might be useful to prevent implantation metastasis of rectal cancer during surgery.