Relationship Between Exfoliated Malignant Cells With Clinicopathological Characteristics During Anterior Resection For Rectal Cancer

Objective:To analyze the risk factors inducing tumor cells exfoliation during anterior resection for rectal cancer.Methods:41 patients with carcinoma of the rectum undergoing anterior resection were prospectively studied. The closed rectal stump was washed before cutting the rectal stump below the tumor. The rectal stump washout was performed uniformly by every incremental 500ml of saline irrigation up to 1 liters through a rectal tube and then the washout sample was collected for cytopathology examination. Outcome date were collected and statistical analysis by Fisher's exact test and chi-squared test.Results:Malignant cells were collected in 8 patients and the positive rate is 19.5%. By univariate analysis,turner size and the distance from turner to anal verge is correlated with shed intraluminal malignant cells(p<0.05).Conclusion:The rectal stump might be have exfoliated malignant cells during anterior resection for rectal cancer. Turner size and the distance from tumer to anal verge is more important factors inducing tumor cells exfoliation.So we must be abide to the principle of free-turner during anterior resection for rectal cancer and the rectal stump is washed by a large amount of saline before insertion of the circular stapler. Because it can eliminate exfoliated malignant cells in the rectum in the vicinity of the anastomosis and then decrease the chance of local recurrence.