Is Rectal Washout Necessary in Anterior Resection for Rectal Cancer? A Prospective Clinical Study

Abstract

There were no differences in terms of the number of patients who had malignant cells collected from the circular stapler and local recurrence rates between the two groups. Although this is not a randomized study and size and mean follow-up time of the study were not sufficient, our results did not offer rational arguments in support of intraoperative rectal washout when a circular stapler is used after low anterior resection for carcinoma. Because of the limitations of our study, however, we are unable to arrive at a definite conclusion regarding rectal washout. There is a need for a randomized, controlled, large-scale, multicenter trial to establish the clinical relevance of intraoperative rectal washout.

Totally laparoscopic sigmoid colectomy with transanal specimen extraction

“…Ooi et al [8] indicated that there is a risk of cancer cell exfoliation, implantation, and local recurrence at the rectal stump opening and recommended the use of a protective barrier or specimen bag to reduce the incidence of these problems. Although rectal washout is performed, there is a risk of remnant tumor cells remaining [13,14]. Therefore, objects such as the specimen, protective barrier, and forceps that come into contact with the rectal mucosa should not subsequently touch the peritoneum.…”

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

“…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].…”

Suture-line recurrence at a jejunojejunal anastomosis after gastrectomy for gastric cancer

“…However, it is not clear whether cytocidal agents are effective in preventing suture-line recurrence at an anastomosis [12].…”