The efficacy of agents employed to prevent anastomotic recurrence in colorectal carcinoma.
Forty-eight of 72 surgeons canvassed in the South West of England (67%) routinely use an intraluminal cytotoxic agent to prevent suture-line recurrence following partial resection of the large bowel for cancer. The most popular agents are chlorhexidine-cetrimide preparations (n = 14), mercuric perchloride (12), povidone-iodine (7) and water (12); noxythiolin, sodium hypochlorite and silver nitrate are used occasionally. The mean duration of treatment is 2 minutes. When assayed for cytotoxity against tumour cells freshly prepared from human colorectal carcinomas (n = 10), both chlorhexidine-cetrimide and povidone-iodine were rapidly lethal at a wide range of concentrations (5-100%). Mercuric perchloride (0.2%) was similarly effective, but up to 20% of tumour cells remained viable after exposure to noxythiolin and nearly 30% with water alone. Chlorhexidine-cetrimide and povidone-iodine are the agents of choice to kill malignant cells exfoliated into the colorectal lumen.
D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use; D002470:Cell Survival / Q000187:drug effects; D000077286:Cetrimonium; D002593:Cetrimonium Compounds / Q000627:therapeutic use; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008627:Mercuric Chloride; D008628:Mercury / Q000627:therapeutic use; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009677:Noxythiolin / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D011206:Povidone-Iodine / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D014867:Water / Q000008:administration & dosage
D000891:Anti-Infective Agents, Local; D002593:Cetrimonium Compounds; D014867:Water; D009677:Noxythiolin; D008627:Mercuric Chloride; D011206:Povidone-Iodine; D008628:Mercury; C010882:chlorhexidine gluconate; D002710:Chlorhexidine; D000077286:Cetrimonium