Recurrence of colonic cancer twice at the site of stapled colorectal anastomosis.
Recurrence at the site of a stapled anastomosis is generally believed to result from the luminal implantation of viable cancer cells during stapling. We report a case in which colon cancer recurred twice at the site of a stapled anastomosis, despite povidone iodine (PVP-I) lavage consisting of an enema with 5% PVP-I solution before the operation and intraoperative lavage of the rectal remnant and the descending colon with a 10% PVP-I solution. Three months after sigmoidectomy to resect a carcinoma of the sigmoid colon, a circular anastomotic recurrence was found at the suture line after anastomosis with a stapler. However, 11 months after the subsequent resection and reanastomosis to remove the first anastomotic recurrence, another anastomotic recurrence was found. We performed abdominoperineal resection for the second recurrence at the site of the stapled anastomosis. Suture-line recurrence could not be prevented in the present case despite lavage with a PVP-I solution for prophylaxis.
Futami
Ryouhei
R
Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. ryouhei@nms.ac.jp
Shimanuki
Kimiyoshi
K
Sugiura
Atsushi
A
Tsuchiya
Yoshikazu
Y
Kaneko
Masahiro
M
Okawa
Keiichi
K
Mineta
Sho
S
Sugiyama
Yoshihiko
Y
Akimaru
Koho
K
Tajiri
Takashi
T
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000714:Anastomosis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009366:Neoplasm Seeding; D011183:Postoperative Complications; D012811:Sigmoid Neoplasms / Q000473:pathology / Q000601:surgery*; D013528:Surgical Staplers