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Se trata de probar la eficacia del lavado del muñón rectal previo a la anastomosis colorrectal, para el arrastre de posibles células exfoliadas durante la disección.
Se valoran 15 pacientes intervenidos de cáncer de recto, a los que se les realizó una resección anterior. Tras la disección rectal se efectúa pinzado por debajo del tumor y triple irrigación del muñón: la primera y la tercera con 500 ml de suero salino fisiológico, que se recogen para estudio citológico. La segunda con 500 ml de povidona yodada al 30%, que se desprecia. La sección rectal y la anastomosis según técnica de doble grapado se realizan por debajo del pinzado y, por tanto, sobre la zona irrigada.
Se evidenciaron células malignas en el 60% del primer lavado y sólo un caso "sospechoso" de malignidad en el tercero (6,7%). Durante el período de control no se han observado recidivas anastomóticas.
El lavado del muñón rectal previo a la anastomosis tras resección de un cáncer de recto nos parece de gran importancia para el arrastre de células exfoliadas, lo que puede contribuir a evitar o disminuir las recidivas en la línea de sutura u otras zonas erosionadas
Se valoran 15 pacientes intervenidos de cáncer de recto, a los que se les realizó una resección anterior. Tras la disección rectal se efectúa pinzado por debajo del tumor y triple irrigación del muñón: la primera y la tercera con 500 ml de suero salino fisiológico, que se recogen para estudio citológico. La segunda con 500 ml de povidona yodada al 30%, que se desprecia. La sección rectal y la anastomosis según técnica de doble grapado se realizan por debajo del pinzado y, por tanto, sobre la zona irrigada.
Se evidenciaron células malignas en el 60% del primer lavado y sólo un caso "sospechoso" de malignidad en el tercero (6,7%). Durante el período de control no se han observado recidivas anastomóticas.
El lavado del muñón rectal previo a la anastomosis tras resección de un cáncer de recto nos parece de gran importancia para el arrastre de células exfoliadas, lo que puede contribuir a evitar o disminuir las recidivas en la línea de sutura u otras zonas erosionadas
Palabras clave:
Cáncer de recto
Exfoliación celular
Lavado rectal
To test the efficacy of rectal stump flushing prior to colorectal anastomosis to wash out possible cells exfoliated during dissection.
The study population consisted of 15 patients who had undergone resection of anterior rectum to treat rectal cancer. After dissection, the rectum was clamped below the level of the tumor and the stump was flushed three times; the first and last irrigations consisted of 500 ml of saline solution, which was collected for cytological study, and the second consisted of 500 ml of 30% povidone-iodine, which was discarded. Rectal transection and double-stapled anastomosis were performed below the clamp and, thus, in the irrigated portion.
Malignant cells were found in 60% of the solution samples from the first flushing and only in one case, in which malignancy was "suspected", from the third flushing (6.7%). There has been no evidence of recurrences at the site of anastomosis during follow-up.
We strongly recommend flushing of the rectal stump prior to anastomosis following resection of rectal cancer to wash out exfoliated cells, as it may contribute to preventing or reducing the rate of recurrence along the suture line or in other damaged tissues
The study population consisted of 15 patients who had undergone resection of anterior rectum to treat rectal cancer. After dissection, the rectum was clamped below the level of the tumor and the stump was flushed three times; the first and last irrigations consisted of 500 ml of saline solution, which was collected for cytological study, and the second consisted of 500 ml of 30% povidone-iodine, which was discarded. Rectal transection and double-stapled anastomosis were performed below the clamp and, thus, in the irrigated portion.
Malignant cells were found in 60% of the solution samples from the first flushing and only in one case, in which malignancy was "suspected", from the third flushing (6.7%). There has been no evidence of recurrences at the site of anastomosis during follow-up.
We strongly recommend flushing of the rectal stump prior to anastomosis following resection of rectal cancer to wash out exfoliated cells, as it may contribute to preventing or reducing the rate of recurrence along the suture line or in other damaged tissues
Keywords:
Rectal cancer
Cell exfoliation
Rectal flushing
