Usefulness of Intraluminal Lavage for Post-operative Anastomosis Recurrence in Rectal Cancer Cases with Double Stapling Technique

Hidejirou Kawahara, Katsuya Hirai, Teruaki Aoki, Keiichi Sato, Masashi Ono, Toshimasa Suzuki

Department of Surgery, The Jikei University School of Medicine

In a retrospective study, we found that there was a strong relationship between the anastomosis technique and anastomosis recurrence. In particular, patients operated on by the double stapling technique (DST) had significantly higher anastomosis recurrence than those in whom other anastomosis techniques were used. After that, advanced rectal cancer patients with DST in the 3 years from 1992 to 1994, were evaluated for the purpose of determining the usefulness of intraluminal lavage in the operation using DST for rectal cancer. The results showed that only if sufficient preoperative intraluminal preparation was carried out, desquamated cancer cells were decreased, and the anastomosis recurrence rate was decreased from 11.8% to 5.8%. However, there was no anastomosis recurrence in 48 patients carried out intraluminal lavage. Therefore it is extremely useful to perform intraluminal lavage just prior to the anastomosis to prevent anastomosis recurrence, and it is conceivable that intraluminal lavage is an essential manipulation in rectal cancer operations using DST.

Key words
anastomosis recurrence in rectal cancer, double stapling technique, intraluminal lavage of rectum, implantation of malignant cell

Reprint requests
Hidejirou Kawahara Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishishinbashi Minato-ku, Tokyo 105 JAPAN

Accepted
October 1, 1997

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