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document
Intraluminal exfoliated cancer cells and effectiveness of bowel ligatures during sigmoidectomy for sigmoid colon cancer . PURPOSES To establish the efficiency of bowel ligatures in colon cancer surgery , focusing on the extent to which exfoliated cancer cells are shed in the colonic lumen during sigmoidectomy . METHODS Twenty consecutive patients who underwent sigmoidectomy for sigmoid colon cancer were prospectively randomized into two groups : the " ligatures group " , in which bowel ligatures were placed , 3 , 5 , 10 cm from the tumor proximally and distally before dissection ; and the " no ligatures group " , in which the corresponding sites were ligated only immediately before taking the specimen out . Each colonic segment ligated was irrigated with saline and samples were sent for blind cytological examination . RESULTS Cancer cells were found in the colonic segment where the tumor was located , in 18 of 20 samples . The frequency of free cancer cells decreased from 50 to 0 % ( p < 0.04 ) in the distal 3-5 cm colonic segment and from 80 to 20 % ( p < 0.03 ) in the proximal colonic segment after performing bowel ligatures . Free cancer cells were confirmed in 1 of 10 samples at both colonic segments 5-10 cm from the tumor , even after bowel ligatures . CONCLUSIONS Intraluminal exfoliated cancer cells could be eliminated by placing bowel ligatures during sigmoidectomy . Measures should be considered to eliminate exfoliated cancer cells during colectomy , even after placing bowel ligatures .
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Intervention_Physical
sigmoidectomy
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Intervention_Surgical
colon cancer surgery
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Intervention_Physical
sigmoidectomy
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Intervention_Surgical
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Intervention_Physical
sigmoidectomy
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Intervention_Surgical
ligatures group
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Intervention_Control
ligatures group
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Intervention_Pharmacological
irrigated with saline
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Participant_Condition
during sigmoidectomy for sigmoid colon cancer
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Participant_Condition
colon cancer surgery
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Participant_Sample-size
Twenty consecutive patients
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Participant_Condition
sigmoidectomy for sigmoid colon cancer
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Participant_Condition
during colectomy