胡康 1 , 陳育民 2 , 張偉 1 , 李平 1 , 王康 1 , 郭志義 1 , 王波 1 , 胡大學 3 , 楊偉明 1
  • 1.四川省醫(yī)學科學院·四川省人民醫(yī)院胃腸外科(成都 610072);;
  • 2. 成都市溫江區(qū)人民醫(yī)院外科(成都 611130);;
  • 3. 四川省醫(yī)學科學院·四川省人民醫(yī)院病理科(成都 610072);

目的  研究直腸癌切除后腸吻合前進行腸腔灌洗的臨床作用。方法  對我院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、行遠端封閉吻合前行生理鹽水遠端腸腔灌洗,收集灌洗前、后2份標本分別涂片行細胞學檢查。結(jié)果  灌洗前收集液中觀察到腫瘤細胞或核異形細胞者7例,中性粒細胞者24例,上皮細胞者4例; 灌洗后所有患者的收集液中均未觀察到腫瘤細胞(P<0.05),19例仍有少許中性粒細胞或上皮細胞。結(jié)論  低位直腸癌遠端腸腔有可能存在脫落的腫瘤細胞。對直腸癌患者手術切除病灶后吻合前行遠端腸腔灌洗的方法簡單易行,可以顯著減少或清除腸腔內(nèi)可能殘留的腫瘤細胞,從而可避免此類原因所致的局部腫瘤復發(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,楊偉明. 直腸癌切除吻合前遠端腸腔灌洗的作用(附56例報道). 中國普外基礎與臨床雜志, 2008, 15(11): 849-850. doi: 復制

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  2. 2. Sobin LH, Wittekind C Eds. UICC: TNM classification of malignant tumours [M]. 6th ed. London: John Wiley & Sons, 2002∶72-76.
  3. 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. 4. 郭 云, 唐宗江. 低位直腸癌術后局部復發(fā)的影響因素及其對策 [J]. 大腸肛門病外科雜志, 2004; 10(1)∶70.
  5. 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.
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  10. 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.