Division of Colon and Rectal Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Department of Surgery, Taipei Medical University, Taipei, Taiwan; Department of Surgery, Mackay Medical College, Taipei, Taiwan.
Division of Colon and Rectal Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Department of Surgery, Mackay Medical College, Taipei, Taiwan; Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan.
Asian J Surg. 2018 Nov;41(6):569-572. doi: 10.1016/j.asjsur.2018.01.006. Epub 2018 Feb 15.
BACKGROUND/OBJECTIVE: The presence of carcinoma cells in the suture line may result in local recurrence. The purpose of this study was to assess whether carcinoma cells were present along the resection line where the distal clamp was applied.
During surgery, the rectum was clamped at least 3 cm distal to the palpable margin of the tumor mass. The rectum was divided distal and proximal to the clamp. The tissue inside the clamp was rinsed with normal saline, and the irrigation solution was sent for cytologic examination.
In 134 patients with carcinoma of the rectosigmoid colon or rectum, we found four (3.0%) cases of positive cytology, and five cases (3.7%) with cytology indicting the presence of atypical cells highly suspicious for malignancy. It was postulated that the trapping of cancer cells in a double-staple anastomosis line may have resulted in local recurrence.
This study indicates that double staple-line recurrence is related to the shedding of cancer cells during dissection and clamping.
背景/目的：缝线处存在癌细胞可能导致局部复发。本研究旨在评估在应用远端夹具的切除线处是否存在癌细胞。
在手术过程中，直肠在距肿瘤肿块可触及边缘至少 3 厘米处被夹住。直肠在夹具的远端和近端被分割。用生理盐水冲洗夹具内的组织，将冲洗液送去细胞学检查。
在 134 例直肠乙状结肠或直肠癌患者中，我们发现 4 例（3.0%）细胞学阳性，5 例（3.7%）细胞学提示存在高度疑似恶性的非典型细胞。据推测，双钉吻合线处的癌细胞捕获可能导致局部复发。
本研究表明，双钉线复发与解剖和夹闭过程中癌细胞的脱落有关。
