Anastomotic recurrence cases after functional end-to-end anastomosis for colon cancer

Abstract

We investigated all the anastomotic recurrence cases after functional end-to-end anastomosis (FEEA) for colon cancer in our hospital between April 2000 and March 2010. In 401 FEEA cases, five recurrent cases at the anasitomosis site of FEEA were identified. Pathological findings of the first operation showed that the depth of tumor invasion were subserosa, lymph node metastasis were positive, and the period until recurrence were less than 2 years in all of the five cases. It is etiologically inferred that implantation of free cancer cells in the intestine might cause the anastomotic recurrence, and we considered two possible mechanisms for the implantation. The first is that free cancer cells are caught into suturing line by the linear stapler, and second is that free cancer cells graft onto the raw surface of the FEEA after anastomosis. We discuss preventive procedures against anastomotic recurrence in FEEA with these mechanisms in mind. It is necessary to define a standard procedure to prevent anastomotic recurrences of colon cancer.