title: Recurrence of colonic cancer twice at the site of stapled colorectal anastomosis.
abstract: 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.
authors.affiliation: Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. ryouhei@nms.ac.jp
authors.forename: Ryouhei
authors.initials: R
authors.lastname: Futami
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Shimanuki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugiura
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tsuchiya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kaneko
authors.forename: Keiichi
authors.initials: K
authors.lastname: Okawa
authors.forename: Sho
authors.initials: S
authors.lastname: Mineta
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: 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