Intraoperative Rectal Washout Using the New Irrigating Proctoscope in Anterior Resection

Koutarou Maeda, Mitsumasa Hashimoto, Hitoshi Katai, Junichi Koh, Osami Yamamoto, Youichirou Hosoda, Kenichi Kawamura*, Motoko Kerematsu*

Department of Surgery and *Pathology, Social Insurance Seitama Chuo Hospital

A new irrigating proctoscope was invented to minimize implantation metastases by reducing exfoliated cororectal cancer cells in the distal rectum during anterior resection for rectal cancer. The proctoscope was used in 12 cases of rectal cancer following the clamping of the distal rectum prior to rectal dissection. Irrigation was performed with 2000 ml of saline after insertion of the proctoscope through the anus. Exfoliated cancer cells in the irrigation fluid were examined cytologically after every 500 ml of irrigation. Exfoliated cancer cells were demonstrated in the first sample of irrigation fluid in all cases, but few cancer cells were demonstrated at the end. The Irrigation time was 5 minutes and 29 seconds. More than 1000 ml of saline was considered to be needed to eliminate the exfoliated cancer cells for rectal cancer below the peritoneal reflection, and more than 2000 ml of saline for cancer above the peritoneal reflection. The new irrigating proctoscope was considerd to be helpful in completing rapid, and effective irrigation without operating theater pollution.

Key words
intraoperative rectal washout in anterior resection, intraoperative rectal irrigation of colorectal cancer, exfoliated cancer cells of colorectal cancer, local recurrence of rectal cancer, implantation metastases of colorectal cancer

Reprint requests
Koutarou Maeda Department of Surgery, Social Insurance Saitama Chuo Hospital
4-9-3, Kitaurawa, Urawa, 338 JAPAN

Accepted
March 2, 1994

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