Intraluminal washout in rectal and sigmoid colon cancer surgeries with double‐stapling technique anastomosis: A single‐institution prospective study
2025

Intraluminal Washout in Rectal and Sigmoid Colon Cancer Surgeries

Sample size: 140 publication Evidence: moderate

Author Information

Author(s): Shinji Furuya, Kensuke Shiraishi, Hiroki Shimizu, Koichi Takiguchi, Makoto Sudo, Hidenori Akaike, Yoshihiko Kawaguchi, Hidetake Amemiya, Tetsuo Kondo, Daisuke Ichikawa

Primary Institution: University of Yamanashi

Hypothesis

This study aimed to determine the necessity of intraluminal washout through cytological assessment to prevent implantation of exfoliated cancer cells (ECCs) in patients with rectal and sigmoid cancers.

Conclusion

In patients with sigmoid colon cancer, a 1000 mL intraluminal washout may be sufficient, while rectal cancer patients may require a 2000 mL washout.

Supporting Evidence

  • 46.4% of patients initially had positive ECCs.
  • After irrigation with 2000 mL, ECCs were found in only 7.3% of patients.
  • Shorter distal free margins were associated with positive ECCs.

Takeaway

Doctors wanted to see if washing out the inside of the intestines during cancer surgery helps stop cancer cells from spreading. They found that washing with 1000 mL is enough for some patients, but others need 2000 mL.

Methodology

The study involved 140 patients who underwent anastomosis surgery, with intraluminal washout samples collected before and after irrigation with varying volumes of saline or distilled water.

Potential Biases

The study's findings may not be generalizable due to its single-institution design.

Limitations

The study was a single-center trial and did not randomize the irrigation solution used.

Participant Demographics

The study included 140 patients, 91 men and 49 women, with an average age of 68.9 years.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1002/ags3.12851

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