Analysis of operative contamination of surgical gear by exfoliated cancer cells in hepatocellular carcinoma: a retrospective study on seventy-eight patients / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the risks of operative contamination of surgical gear by exfoliated cancer in 78 patients who received surgery for hepatocellular carcinoma.Methods Surgical gear from 78 patients who were operated for primary hepatocellular carcinoma were divided into four groupsA.surgical instruments; B.surgeon gloves; C.gauze and gloves used for cleaning equipment; D.gauze and gauze pad used for cleaning operation area.Saline was used to soak the surgical gear followed by low speed centrifugation.The precipitate was stained and then observed for cancer cells.Results The positive rates of cancer cell on surgical gear were significantly associated with the TNM stage,tumor location,tumor size,and surgical approach.The positive rate of liver cancer cell on surgical gear in TNM stage Ⅲ was higher than TNM stage Ⅰ / Ⅱ (56.3％ vs 21.7％,P=0.002).The positive rate of cancer cell on surgical gear was significantly related to tumor size and location (P=0.006,P=0.001).The positive cancer cell detection rate of non-anatomical liver resection was significantly higher than anatomical resection (53.8 ％ vs 26.9 ％,P =0.019).The positive cancer cell detection rate was significantly associated with different types of surgical gear (P=0.008),in which group C showed the highest cancer cell detection rate.Conclusion The risks of cancer cell contamination of surgical gear were significantly associated with progression of hepatocellular carcinoma,tumor size,location and surgical approach,and also associated with the frequency in the use of surgical gear,the operation scope of contact and the nature of surgical gear.