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 , 陳育民 ² , 張偉 ¹ , 李平 ¹ , 王康 ¹ , 郭志義 ¹ , 王波 ¹ , 胡大學 ³ , 楊偉明 ¹

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Keywords：

直腸; 灌洗; 惡性; 脫落

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目的研究直腸癌切除后腸吻合前進行腸腔灌洗的臨床作用。方法對我院2006年6月至2007年2月期間連續56例行直腸癌低位前切除吻合的病例在切除原發灶、行遠端封閉吻合前行生理鹽水遠端腸腔灌洗，收集灌洗前、后2份標本分別涂片行細胞學檢查。結果灌洗前收集液中觀察到腫瘤細胞或核異形細胞者7例，中性粒細胞者24例，上皮細胞者4例；灌洗后所有患者的收集液中均未觀察到腫瘤細胞（P＜0.05），19例仍有少許中性粒細胞或上皮細胞。結論低位直腸癌遠端腸腔有可能存在脫落的腫瘤細胞。對直腸癌患者手術切除病灶后吻合前行遠端腸腔灌洗的方法簡單易行，可以顯著減少或清除腸腔內可能殘留的腫瘤細胞，從而可避免此類原因所致的局部腫瘤復發，值得提倡。

Citation： 胡康,陳育民,張偉,李平,王康,郭志義,王波,胡大學,楊偉明. 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. 低位直腸癌術后局部復發的影響因素及其對策 [J]. 大腸肛門病外科雜志, 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. 吳階平，裘法祖主編. 黃家駟外科學 [M]. 中冊. 第6版. 北京: 人民衛生出版社， 2000∶1135～1136.
7. 中國醫學科學院腫瘤研究所腫瘤醫院細胞學室主編. 臨床腫瘤細胞學圖譜 [M]. 第1 版. 北京: 人民衛生出版社, 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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