Effect of Rectal Stump Lavage Before Anastomosis of Anterior Resection for Rectal Cancer (Report of 56 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

胡康 ¹ , 陈育民 ² , 张伟 ¹ , 李平 ¹ , 王康 ¹ , 郭志义 ¹ , 王波 ¹ , 胡大学 ³ , 杨伟明 ¹

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Keywords：

直肠; 灌洗; 恶性; 脱落

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目的研究直肠癌切除后肠吻合前进行肠腔灌洗的临床作用。方法对我院2006年6月至2007年2月期间连续56例行直肠癌低位前切除吻合的病例在切除原发灶、行远端封闭吻合前行生理盐水远端肠腔灌洗，收集灌洗前、后2份标本分别涂片行细胞学检查。结果灌洗前收集液中观察到肿瘤细胞或核异形细胞者7例，中性粒细胞者24例，上皮细胞者4例；灌洗后所有患者的收集液中均未观察到肿瘤细胞（P＜0.05），19例仍有少许中性粒细胞或上皮细胞。结论低位直肠癌远端肠腔有可能存在脱落的肿瘤细胞。对直肠癌患者手术切除病灶后吻合前行远端肠腔灌洗的方法简单易行，可以显著减少或清除肠腔内可能残留的肿瘤细胞，从而可避免此类原因所致的局部肿瘤复发，值得提倡。

Citation： 胡康,陈育民,张伟,李平,王康,郭志义,王波,胡大学,杨伟明. Effect of Rectal Stump Lavage Before Anastomosis of Anterior Resection for Rectal Cancer (Report of 56 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(11): 849-850. doi: Copy

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1. Jenner DC, de Boer WB, Clarke G, et al. Rectal washout eliminates exfoliated malignant cells [J]. Dis Colon Rectum， 1998; 41(11)∶1432.
2. Sobin LH, Wittekind C Eds. UICC: TNM classification of malignant tumours [M]. 6th ed. London: John Wiley ＆ Sons, 2002∶72-76.
3. Ross A, Rusnak C, Weinerman B, et al. Recurrence and survival after surgical management of rectal cancer [J]. Am J Surg， 1999; 177(5)∶392.
4. 郭云, 唐宗江. 低位直肠癌术后局部复发的影响因素及其对策 [J]. 大肠肛门病外科杂志, 2004； 10(1)∶70.
5. Hubens G, Lafullarde T, Van Marck E, et al. Implantation of colon cancer cells on intact and damaged colon mucosa and serosa: an experimental study in the rat [J]. Acta Chir Belg， 1994; 94(5)∶258.
6. 吴阶平，裘法祖主编. 黄家驷外科学 [M]. 中册. 第6版. 北京: 人民卫生出版社， 2000∶1135～1136.
7. 中国医学科学院肿瘤研究所肿瘤医院细胞学室主编. 临床肿瘤细胞学图谱 [M]. 第1 版. 北京: 人民卫生出版社, 1976∶126～155.
8. Sayfan J, Averbuch F, Koltun L， et al. Effect of rectal stump washout on the presence of free malignant cells in the rectum during anterior resection for rectal cancer [J]. Dis Colon Rectum， 2000; 43(12)∶1710.
9. Mariani PP, van Pelt JF, Ectors N, et al. Rectal washout with cytotoxic solution can be extended to the whole colon [J]. Br J Surg， 2002; 89(12)∶1540.
10. Terzi C, Unek T, Saˇ〖〗gol O, et al. Is rectal washout necessary in anterior resection for rectal cancer? A prospective clinical study [J]. World J Surg， 2006; 30(2)∶233.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Rectal Stump Lavage Before Anastomosis of Anterior Resection for Rectal Cancer (Report of 56 Cases)

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