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Exfoliated cancer cells during intersphincteric resection for very low rectal cancer.
Koide, Yoshikazu; Maeda, Kotaro; Katsuno, Hidetoshi; Hanai, Tsunekazu; Masumori, Koji; Matsuoka, Hiroshi; Endo, Tomoyoshi; Cheong, Yeong Cheol; Uyama, Ichiro.
Afiliación
  • Koide Y; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
  • Maeda K; International Medical Center, Fujita Health University Hospital, 1-98, Kutsukake, Toyoake, Aichi, 470-1192, Japan. kmaeda@fujita-hu.ac.jp.
  • Katsuno H; Department of Surgery, Fujita Health University Okazaki Medical Center, Okazaki, Japan.
  • Hanai T; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
  • Masumori K; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
  • Matsuoka H; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
  • Endo T; Department of Surgery, Fujita Health University Okazaki Medical Center, Okazaki, Japan.
  • Cheong YC; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
  • Uyama I; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
Surg Today ; 50(12): 1652-1656, 2020 Dec.
Article en En | MEDLINE | ID: mdl-32617675
PURPOSE: To investigate the frequency of exfoliated cancer cells and the efficacy of rectal washout during intersphincteric resection (ISR) in patients not receiving chemoradiotherapy (CRT) for very low rectal cancer. METHOD: The subjects of this prospective study were 16 consecutive patients who underwent ISR without CRT for very low rectal cancer. Brushing cytology of the posterior anorectal wall was performed twice in each step of the ISR procedure and the samples were sent for blind cytological examination to identify exfoliated cancer cells. RESULTS: Exfoliated cancer cells were identified in 9 of 13 patients (69%) preoperatively. The number of cancer cells identified after abdominal total mesorectal dissection decreased significantly from 94% (15/16) to 25% (4/16) after transanal irrigation with 2000 mL saline (p < 0.001). No cancer cells were identified after swabbing the anal wall following transanal dissection with purse-string closure of the distal stump. No suture-line recurrence was found during a median follow-up duration of 6 years. CONCLUSION: Exfoliated cancer cells, confirmed in 94% of patients after total mesorectal excision, could be eliminated by performing rectal irrigation after clamping the rectum proximal to the tumor and swabbing the anorectal wall during ISR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Canal Anal / Neoplasias del Recto / Recto / Procedimientos Quirúrgicos del Sistema Digestivo / Suturas / Tratamientos Conservadores del Órgano / Irrigación Terapéutica / Recurrencia Local de Neoplasia / Siembra Neoplásica Tipo de estudio: Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Surg Today Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Canal Anal / Neoplasias del Recto / Recto / Procedimientos Quirúrgicos del Sistema Digestivo / Suturas / Tratamientos Conservadores del Órgano / Irrigación Terapéutica / Recurrencia Local de Neoplasia / Siembra Neoplásica Tipo de estudio: Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Surg Today Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón