Abstract
We examined the relationship between exfoliated malignant cells collected by intraluminal lavage in anterior resection and anastomosis recurrence.
In 34 cases of rectal cancer (the lavage group), we washed the distal rectum with 2000ml of normal saline before rectal dissection, and determined cytologically the existence of exfoliated malignant cells in the irrigation fluid, In 18 cases in the lavage group. we also examined exfoliated malignant cells that stuck to oral and anal bowel stumps pierced by the double stapling technique, and their viabilities. Thirty-five in patients whom washing was not performed (the non-lavage group) were examined for contrast regarding the anastomosis recurrence rate.
Intraluminal lavage by 2000ml of saline decreased the number of exfoliated malignant cells in the rectum, compared with washout by 100ml of saline (p=0.001). Though there was no significant difference, intraluminal lavage by 2000ml of saline decreased the anastomosis recurrence rate compared with that in the non-lavage group (p=0.614). We detected 33.3% of exfoliated malignant cells in the oral and anal bowel stumps, and these had high viability.
It is considered that we must devise a method to wash such cells out.
