Irrigation Volume Determines the Efficacy of “Rectal Washout”

Maeda, Koutarou; Maruta, M.; Hanai, Taizo; Sato, Harunobu; Horibe, Yoshimune

doi:10.1007/s10350-004-0659-z

Cited by 58 publications

(47 citation statements)

References 21 publications

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“…Alternatively, it may be just another manifestation of neoplastic progression when tumour starts producing autonomous potentially metastatic cells ready for secondary implantation. The latter assumption is corroborated by the cited reports of secondary anal metastases after removal of primary colorectal cancers [33][34][35] or peritoneal cancer dissemination during operations. 36 However, the 2 mechanisms are likely to be inseparably entangled since well-preserved colonocytes, apoptotic cells and cell debris are all abundant in the mucocellular layer of cancer patients.…”

Section: Cell Exfoliation In the Colonic Epithelium: Its Role In Normsupporting

confidence: 61%

“…The findings were perfectly in line with clinical reports describing secondary distal, especially anal, tumours in colorectal cancer patients. [33][34][35] Such tumours, albeit rare, appear to result from an unusual metastatic process involving the reimplantation of viable exfoliated malignant cells migrating within the mucocellular layer. Likewise, occasional intraperitoneal seeding of exfoliated cancer cells during surgery for colorectal cancer can lead to peritoneal carcinomatosis.…”

Section: Cell Exfoliation In the Colonic Epithelium: Its Role In Normmentioning

confidence: 99%

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Cell exfoliation in the human colon: Myth, reality and implications for colorectal cancer screening

Loktionov

2007

Intl Journal of Cancer

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Colonocyte exfoliation in the human colon constitutes a unique mechanism of cell population control that can undergo significant changes under different physiological and pathological conditions. Being closely related to the apoptosis and anoikis, cell exfoliation from colonic epithelium appears to be a relatively rare event in normal conditions, but its rate dramatically increases in neoplasia, when cell removal by apoptosis in situ does not function properly. Several studies show that significant numbers of exfoliated colonocytes are not lost in the faecal contents of the gut, but retained in the mucocellular layer overlying colonic mucosa. Recent observations allow hypothesizing that the mucocellular layer containing exfoliated colonocytes may gradually migrate distally, eventually leading to the accumulation of the cells exfoliated from malignant colorectal tumours on the surface of the rectal mucosa. Implications of exfoliated colonocyte analysis to colorectal cancer screening and early diagnosis are discussed. ' 2007 Wiley-Liss, Inc.Key words: colonic epithelium; cell exfoliation; mucocellular layer; neoplastic growth; colorectal cancer screening Intense investigation of epithelial cell proliferation in the mammalian intestinal mucosa has resulted in a significant progress in understanding regulatory mechanisms governing cell dynamics in this rapidly self-renewing cell population. This understanding greatly assisted in developing theoretical models of human colorectal carcinogenesis addressing both its molecular mechanisms [1][2][3][4] and sequences of events in tumour morphogenesis. [5][6][7][8][9][10] As numerous studies in this area were devoted to the investigation of colonocyte proliferation and differentiation, relatively little remained known about the final natural destiny of these cells. Obligatory exfoliation of terminally differentiated colonocytes was traditionally believed to be the predominant way of cell loss in colonic epithelium, 11 but this popular notion remained essentially hypothetical in the absence of convincing firm evidence. Given that it has become generally admitted that exfoliated colonocyte analysis may open new approaches to colorectal cancer screening and early diagnosis, detailed knowledge and better understanding of the exfoliation of colonic epithelium and its changes in neoplasia is of high practical relevance. The present brief review addresses this surprisingly obscure area with the purpose of clarifying a few points still provoking controversy and confusion. Perspectives of using the phenomenon of colonic cell exfoliation for screening and diagnosis of colorectal cancer and related diseases are then reevaluated in view of recent advances in the field.Cell exfoliation in the colonic epithelium: Its role in normal physiological conditions and neoplasia Colonic epithelium is known to be one of the most dynamic cell populations of the human organism. 4,8,11,12 Meticulous investigation of the well-structured organisation of the colonic mucosa allowed constructing a detaile...

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Section: Cell Exfoliation In the Colonic Epithelium: Its Role In Normsupporting

confidence: 61%

Section: Cell Exfoliation In the Colonic Epithelium: Its Role In Normmentioning

confidence: 99%

Cell exfoliation in the human colon: Myth, reality and implications for colorectal cancer screening

Loktionov

2007

Intl Journal of Cancer

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“…Data from clinical and experimental studies show that irrigation fluid from the rectal stump contains a large number of exfoliated tumour cells 30,31 , which in vitro and in an immunosuppressed animal model have the potential for further growth 32,33 . Other studies have shown that exfoliated tumour cells are regularly found on stapling devices and may be implanted on the staple line 34,35 .…”

Section: Discussionmentioning

confidence: 99%

Impact of anastomotic leakage on oncological outcome after rectal cancer resection

Ptok

Marusch

Meyer

et al. 2007

British Journal of Surgery

179

116

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“…Although rectal washout has been reported to eliminate exfoliated malignant cells [3,4,15,16], no data indicating a reduction of anastomotic implantation have been demonstrated [17,18]. Furthermore, this study was unable to Although it remains controversial in regard to whether an intensive follow-up program including rectosigmoidoscopy can improve survival [19,20], intensive flexible rectosigmoidoscopy is recommended in the guidelines for colorectal cancer surveillance [21,22].…”

Section: Discussionmentioning

confidence: 66%

Clinicopathological features of anastomotic recurrence after an anterior resection for rectal cancer

Matsuda

Hotta

Takifuji

et al. 2009

Langenbecks Arch Surg

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Irrigation Volume Determines the Efficacy of “Rectal Washout”

Cited by 58 publications

References 21 publications

Cell exfoliation in the human colon: Myth, reality and implications for colorectal cancer screening

Cell exfoliation in the human colon: Myth, reality and implications for colorectal cancer screening

Impact of anastomotic leakage on oncological outcome after rectal cancer resection

Clinicopathological features of anastomotic recurrence after an anterior resection for rectal cancer

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