Intraluminal Exfoliated Cancer Cells and Effectiveness of Bowel Ligatures During Sigmoidectomy for Sigmoid Colon Cancer

Overview

Journal Surg Today

Specialty General Surgery

Date 2013 Dec 10

PMID 24318457

Citations 6

Authors

Kotaro Maeda

Tsunekazu Hanai

Harunobu Sato

Koji Masumori

Yoshikazu Koide

Hiroshi Matsuoka

Hidetoshi Katsuno

Makoto Kuroda

Affiliations

Soon will be listed here.

Abstract

Purposes: To establish the efficiency of bowel ligatures in colon cancer surgery, focusing on the extent to which exfoliated cancer cells are shed in the colonic lumen during sigmoidectomy.

Methods: Twenty consecutive patients who underwent sigmoidectomy for sigmoid colon cancer were prospectively randomized into two groups: the "ligatures group", in which bowel ligatures were placed, 3, 5, 10 cm from the tumor proximally and distally before dissection; and the "no ligatures group", in which the corresponding sites were ligated only immediately before taking the specimen out. Each colonic segment ligated was irrigated with saline and samples were sent for blind cytological examination.

Results: Cancer cells were found in the colonic segment where the tumor was located, in 18 of 20 samples. The frequency of free cancer cells decreased from 50 to 0 % (p < 0.04) in the distal 3-5 cm colonic segment and from 80 to 20 % (p < 0.03) in the proximal colonic segment after performing bowel ligatures. Free cancer cells were confirmed in 1 of 10 samples at both colonic segments 5-10 cm from the tumor, even after bowel ligatures.

Conclusions: Intraluminal exfoliated cancer cells could be eliminated by placing bowel ligatures during sigmoidectomy. Measures should be considered to eliminate exfoliated cancer cells during colectomy, even after placing bowel ligatures.

Citing Articles

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Implantation metastasis from sigmoid colon cancer to rectal anastomosis proved by whole exome sequencing and lineage inference for cancer heterogeneity and evolution analysis: Case report and literature review.

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Tan W, Ng N, Chen Y, Chee Y, Foo F, Tang C BMC Gastroenterol. 2018; 18(1):133.

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