Two cases of colon cancer recurrence at the hand-sewn anastomosis site after colectomy

Abstract

We report two cases of colon canser recurrence at the anastomosis site after colectomy, most likely due to implantation of exfoliated cancer cells. Both cases had advanced cancer at the primary surgery and we performed the operations with a hand-sewn anastomosis under laparotomy. The ratio of colon cancer recurrence at the anastomosis site in our department, and we usually perform a hand-sewn anastomosis, was 0.92% (2/217cases) between 2000 and 2009. We did not perform bowel cleaning prior to anastomosis or use povidone-iodine pledgets at the primary operations. Local recurrence probably originated from implantaion. Effective means must be developed to prevent recurrence at the anastomosis site.