Positive detection of exfoliated colon cancer cells on linear stapler cartridges was associated with depth of tumor invasion and preoperative bowel preparation in colon cancer.

BACKGROUND: The aim of this study was to investigate exfoliated cancer cells (ECCs) on linear stapler cartridges used for anastomotic sites in colon cancer. METHODS: We prospectively analyzed ECCs on linear stapler cartridges used for anastomosis in 100 colon cancer patients who underwent colectomy. Having completed the functional end-to-end anastomosis, the linear stapler cartridges were irrigated with saline, which was collected for cytological examination and cytological diagnoses were made by board-certified pathologists based on Papanicolaou staining. RESULTS: The detection rate of ECCs on the linear stapler cartridges was 20 %. Positive detection of ECCs was significantly associated with depth of tumor invasion (p = 0.012) and preoperative bowel preparation (p = 0.003). There were no marked differences between ECC-positive and ECC-negative groups in terms of the operation methods, tumor location, histopathological classification, and surgical margins. CONCLUSIONS: Since ECCs were identified on the cartridge of the linear stapler used for anastomosis, preoperative mechanical bowel preparation using polyethylene glycol solution and cleansing at anastomotic sites using tumoricidal agents before anastomosis may be necessary to decrease ECCs in advanced colon cancer.

[A case of cecal cancer with abdominal wall abscess].

A 63-year-old woman was admitted to our hospital for a palpable mass and abdominal pain. Abdominal CT showed an abscess in the abdominal wall and a contiguous mass in the intraperitoneal cavity. After drainage of the abscess was performed, we conducted a colonoscopy to investigate the cause of the mass. It revealed a type 2 tumor and a whole-circumferential stenosis in the cecum. It required preoperative chemotherapy with CPT-11 and S-1 to achieve radical cure characteristics with the operation. Because there was tumor reduction, right hemicolectomy and resection of the abdominal wall were performed. The patient was discharged 15 days after the operation with an eventful clinical course. Although 5 years have passed since the operation, she is alive and has had no recurrence. This patient accepted tumor reduction by chemotherapy , and the abdominal wall deficit that resulted from excision did not have it was it with a small range, and to rebuild the abdominal wall. The utility of preoperative chemotherapy is recommended in colon cancer which invades other organs.

[A case or resection of synchronous multiple liver metastases from rectal cancer after FOLFOX4 therapy].

A 7 0-year-old man with multiple liver metastases from rectal cancer was admitted to our hospital. From imaging inspection, a resection was determined to be difficult, so he was treated with FOLFOX4 therapy. After ten courses of FOLFOX4, the liver metastases showed 52% reduction in size and were judged to be PR. Therefore low anterior resection of the rectum, left lobectomy of the liver and partial resection of the liver(S7, S8)were performed. He was able to undergo curative surgery after FOLFOX4 therapy.