目的 研究直腸癌切除后腸吻合前進(jìn)行腸腔灌洗的臨床作用。方法 對(duì)我院2006年6月至2007年2月期間連續(xù)56例行直腸癌低位前切除吻合的病例在切除原發(fā)灶、行遠(yuǎn)端封閉吻合前行生理鹽水遠(yuǎn)端腸腔灌洗,收集灌洗前、后2份標(biāo)本分別涂片行細(xì)胞學(xué)檢查。結(jié)果 灌洗前收集液中觀(guān)察到腫瘤細(xì)胞或核異形細(xì)胞者7例,中性粒細(xì)胞者24例,上皮細(xì)胞者4例; 灌洗后所有患者的收集液中均未觀(guān)察到腫瘤細(xì)胞(P<0.05),19例仍有少許中性粒細(xì)胞或上皮細(xì)胞。結(jié)論 低位直腸癌遠(yuǎn)端腸腔有可能存在脫落的腫瘤細(xì)胞。對(duì)直腸癌患者手術(shù)切除病灶后吻合前行遠(yuǎn)端腸腔灌洗的方法簡(jiǎn)單易行,可以顯著減少或清除腸腔內(nèi)可能殘留的腫瘤細(xì)胞,從而可避免此類(lèi)原因所致的局部腫瘤復(fù)發(fā),值得提倡。
引用本文: 胡康,陳育民,張偉,李平,王康,郭志義,王波,胡大學(xué),楊偉明. 直腸癌切除吻合前遠(yuǎn)端腸腔灌洗的作用(附56例報(bào)道). 中國(guó)普外基礎(chǔ)與臨床雜志, 2008, 15(11): 849-850. doi: 復(fù)制
版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
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(shù)后局部復(fù)發(fā)的影響因素及其對(duì)策 [J]. 大腸肛門(mén)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(xué) [M]. 中冊(cè). 第6版. 北京: 人民衛(wèi)生出版社, 2000∶1135~1136. |
7. | 中國(guó)醫(yī)學(xué)科學(xué)院腫瘤研究所腫瘤醫(yī)院細(xì)胞學(xué)室主編. 臨床腫瘤細(xì)胞學(xué)圖譜 [M]. 第1 版. 北京: 人民衛(wèi)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. |
- 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(shù)后局部復(fù)發(fā)的影響因素及其對(duì)策 [J]. 大腸肛門(mén)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(xué) [M]. 中冊(cè). 第6版. 北京: 人民衛(wèi)生出版社, 2000∶1135~1136.
- 7. 中國(guó)醫(yī)學(xué)科學(xué)院腫瘤研究所腫瘤醫(yī)院細(xì)胞學(xué)室主編. 臨床腫瘤細(xì)胞學(xué)圖譜 [M]. 第1 版. 北京: 人民衛(wèi)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.